Application Of T1WI Semi-quantitative Analysis Combined With TMS Scoring System In Predicting Developmental Delay In Preterm Infants

Objective Exploring the value of semi-quantitative analysis of T1 WI combined with TMS scoring system in predicting developmental delay in preterm infants.Methods A total of 850 neonates hospitalized in our hospital from January 2010 to December 2018 were retrospectively selected,and 171 neonates with no significant abnormalities detected by conventional MRI examination and with clinical follow-up of neurodevelopmental Gesell scores for more than two years were screened,of which 109 preterm infants with gestational age <38 weeks were used as the experimental group and 62 full-term infants with gestational age ≥38 weeks were used as the control group,and all subjects were first The total maturational scores(TMS)were performed and the relative T1 WI signal intensities(RI)of the different regions of interest were measured.A two-sample t-test was performed for TMS scores and RI values in the preterm and term groups,and Spearman’s analysis was applied to determine the correlation between TMS scores and RI values and Gesell’s score.The diagnostic efficacy of TMS combined with RI values at different sites was determined using the receiver operating characteristic curve(ROC)for the diagnosis of developmental delay in the Gesell score.Results In this study,109 preterm infants and 62 term infants were included.The mean values of myelination,cortical coiling,and germinal matrix in the preterm group were lower than those in the term group,and the differences were significant(P<0.05).The mean values of TMS in the normal developmental group were higher than those in the delayed group,and the mean values of myelination in the normal developmental group were higher than those in the delayed group,with significant differences(P<0.05);the mean values of RI in the preterm group were lower than those in the term group,with significant differences(P<0.05),and the mean values of RI in the normal developmental group were higher than those in the delayed group in the preterm group.The differences were significant(P<0.05)in the middle part and caudal part of the hind limb of the internal capsule.In preterm infants(Gesell),the mean values of large motor energy areas were higher in the group with normal development than in the delayed group,and the differences in(RI)pale bulb,endocapsular knee,middle endocapsular hind limb,and caudal endocapsular hind limb were significant(P<0.05),and the differences in(RI)fine motor energy areas were higher in the group with normal development than in the delayed group in preterm infants(Gesell),and the differences in(RI)radial crown,endocapsular knee,and middle endocapsular hind limb were significant.The correlation between TMS and RI values in Gesell’s total score and each energy area showed that the correlation coefficients of endocapsular knee,middle endocapsular hind limb,and caudal area with gross motor were 0.8683,0.8110,and 0.7925,respectively(p<0.001),which were higher than the correlation coefficients of myelination and cortical curl with gross motor in TMS(0.5133 and 0.6689).The diagnostic efficacy of ROC curve for developmental delay in TMS combined with RI as a test variable showed that the AUCs of myelination,endocapsular knee RI,and myelination combined with endocapsular knee RI in the area under the gross motor energy area curve were 0.774,0.709,and 0.869,respectively,and the AUCs of endocapsular hindlimb RI and myelination combined with endocapsular hindlimb RI in the area under the gross motor energy area curve were(0.650,0.817),the diagnostic efficacy of myelination combined with RI values in different regions of interest was higher than that of myelination and RI values alone for developmental delays.Conclusions TMS combined with semi-quantitative analysis of T1WI(RI values)can more reliably predict developmental delays in the motor-competent areas of the Gesell score in newborns.