MRI Findings And Clinical Related Factors Of Focal White Matter Damage In Premature

Objective Explore the influencing factors of PWMD in preterm infants,and mainly analyze the relationship between different gestational age and birth weight and types of PWMD in premature;Analysis the best MRI examination time for PWMD in preterm infants;Defining the diagnostic value of DWI squence in PWMD.Methods A total of 153 premature diagnosed with PWMD and 109 premature with normal MRI characteristics were hospitalized in the neonatology ward of our Hospital from November 2013 to December 2017 enrolled in this study.Using logistic regression analysis to discuss whether the series causes of PWMD are protective or risk factors,chi-square test and rank sum test used to mainly analyze the gestational age and birth weight among the factors;In addition,use rank sum test to analyze the optimal MRI examination time for PWMD.Results The influencing factors for PWMD were early preterm infants,low birth weight,respiratory distress,respiratory infection,maternal infection during pregnancy,caesarean section,umbilical cord around neck,and premature rupture of membranes;among them,respiratory tract infections(OR=3.620,P=0.000),respiratory distress(OR=2.928,P=0.003)and premature rupture of membranes(OR=2.104,P=0.017)were risk factors;cesarean section(OR=0.376,P=0.002),late preterm infants(OR=0.277,P=0.000)and normal birth weight(OR=0.447,P=0.013)were protective factors.Late preterm infants have a higher incidence of point and cluster injuries than early preterm infants;early preterm infants have a higher incidence of linear injuries than that of late preterm infants;As weight gaining,the proportion of point and cluster injuries will increase;while the proportion of linear injuries will less.The MRI examination time within 1 week,1 to 2 weeks,and more than 2 weeks the detection rate of DWI was 100%,95.0%,61.7% and 93.7%,91.9%,86.0% in T1 WI,respectively.DWI detection rate is higher than the conventional T1 WI sequence,T1 WI and T2 WI combined with DWI sequences could effectively increase the detection rate when examining within 2 weeks.Conclusions Preterm infants with respiratory system infection,respiratory distress and premature rupture of fetal membranes are quite possible to suffer from PWMD.Early premature and lighter birth weight are more likely to suffer from linear types injuries,meanwhile,the prognosis are worse.The best examination time for MRI in premature is within 2 weeks after birth.DWI combined with conventional T1 WI and T2 WI can effectively improve the detection rate of injuries.