The Recent Mri Outcomes Of 46 Preterm Infants With Punctate White Matter Damage

Objective: To investigate the characteristics of preterm infants with punctate white matter damage(PWMD)diagnosed earlily by conventional MRI and DWI,and observe their recent MRI outcomes.Methods: Selected 46 cases of premature infants as the research objects,who were hospitalized in the First Neonatology Ward of Shengjing Hospital of China Medical University from January 2017 to December 2019 and diagnosed as PWMD by conventional MRI and DWI,all infants completed the first MRI and DWI examination within 14 days after birth,and recently completed the second MRI and DWI examination in the hospital(interval between 11-68 days).According to the shape,number,and distribution characteristics of the MRI lesions,they were divided into spot,cluster and linear lesions,analyzed the MRI characteristics of premature infants with different types of PWMD,and observed their recent MRI outcomes.Results: The results of the initial examination showed that among 46 cases of PWMD,45 cases(97.8%)showed hypersignal on DWI in periventricular and the centrum semiovale white matter,of which 2 cases showed only hypersignal on DWI without conventional MRI signal changes;44 cases(95.7%)showed hupersignal on T1 WI with or without hyposignal on T2 WI,and 1 case did not have hypersignal in the corresponding area on DWI;46 cases of PWMD were divided into spot group(24 cases),cluster group(8 cases)and linear group(14 cases)according to the characteristics of the lesion,there were no statistically significant differences(P<0.05)among the 3 groups in gestational age at birth,age at the first examination,gestational age at the first examination,birth weight,gender,the history of asphyxia.Recent reexamined(3 cases were only reexamined with conventional MRI without DWI)results showed: 19 cases(41.3%)disappeared,25 cases(54.3%)showed hypersignal on T1 WI,with or without hypersignal on T2 WI,only 7 cases showed hypersignal on DWI and the lesions areas were smaller compared with the previous lesions,2 cases(4.3%)showed hypersignal on T1 WI,with hypersignal on T2 WI and DWI.15 cases(62.5%)of the lesions in the spot group were absorbed and disappeared,9 cases(37.5%)were smaller than the previous lesions,2 cases(25%)in the cluster group were completely absorbed and disappeared,6cases(75%)were smaller,and 2 cases in the linear group(14.3%)were absorbed and disappeared,10 cases(71.4%)were smaller and 2 cases(14.3%)evolved into periventricular leukomalacia(PVL).Conclusion: DWI helps early identification of PWMD in premature infants.The recent MRI outcomes of premature infants with PWMD: 41.3% of the lesions were absorbed and disappeared,54.3% were smaller,and 4.3% evolved into PVL,and most of spot and cluster lesions were disappeared or smaller,and linear lesions are more likely to evolved into PVL.Early MRI monitoring can improve the reliability of the diagnosis of PWMD in premature infants.