Mistry Karen H, Bora Samudragupta, Pannek Kerstin, Pagnozzi Alex M, Fiori Simona, Guzzetta Andrea, Ware Robert S, Colditz Paul B, Boyd Roslyn N, George Joanne M
Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia.
Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, Australia; Health Services Research Center, University Hospitals Research & Education Institute, Department of Pediatrics, University Hospitals Rainbow Babies & Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, USA.
Neuroimage Clin. 2025;45:103725. doi: 10.1016/j.nicl.2024.103725. Epub 2024 Dec 14.
This study aimed to (1) evaluate associations between Early and Term structural MRI (sMRI) brain abnormality scores and adverse motor outcomes at 6-years corrected age (CA), (2) determine their diagnostic accuracy in predicting adverse motor outcomes and cerebral palsy (CP) at 6-years CA.
Infants born < 31-weeks gestational age (GA) returning for 6-year follow-up were included. Early and Term sMRI were scored using a validated method, deriving white matter, cortical grey matter, deep grey matter, cerebellar and global brain abnormality scores (GBAS). At 6-years CA, Movement Assessment Battery for Children-2nd Edition (MABC-2) was administered. Linear regression assessed associations between Early and Term GBAS/subscale scores and 6-year MABC-2 total score. For diagnostic accuracy, sMRI scores were categorised as none/mild vs moderate/severe, MABC-2 cut-off ≤ 5th percentile, and CP as present/absent.
Infants had Early MRI (n = 123) at mean PMA 32.5-weeks (median GA 28.4-weeks; mean birthweight 1101 g) and n = 114 had Term MRI (Mean PMA 40.8-weeks). Nine had CP and n = 116 had MABC-2 scores. Early (B: -1.92; p ≤ 0.001) and Term (B: -1.67; p ≤ 0.01) GBAS were negatively associated with MABC-2 scores. Both Early and Term GBAS had high specificity (Sp) and low sensitivity (Se) in predicting MABC-2 ≤ 5th percentile (Early: Se 36 %, Sp 82 %; Term: Se 28 %, Sp 93 %) and predicted CP with high Se and Sp (Early: Se 78 %, Sp 78 %; Term: Se 75 %, Sp 89 %).
High Sp of Early and Term MRI predicting an outcome on MABC-2 may help accurately identify infants unlikely to develop motor impairments at 6-years CA.
本研究旨在（1）评估早期和足月结构性磁共振成像（sMRI）脑异常评分与6岁矫正年龄（CA）时的不良运动结局之间的关联，（2）确定其在预测6岁CA时不良运动结局和脑瘫（CP）方面的诊断准确性。
纳入孕周<31周的婴儿进行6年随访。采用经过验证的方法对早期和足月sMRI进行评分，得出白质、皮质灰质、深部灰质、小脑和全脑异常评分（GBAS）。在6岁CA时，进行儿童运动评估量表第二版（MABC-2）测试。线性回归评估早期和足月GBAS/子量表评分与6岁MABC-2总分之间的关联。对于诊断准确性，将sMRI评分分为无/轻度与中度/重度，MABC-2临界值≤第5百分位数，CP分为存在/不存在。
婴儿平均出生后32.5周（中位孕周28.4周；平均出生体重1101g）时进行了早期MRI（n = 123），114例婴儿进行了足月MRI（平均出生后40.8周）。9例患有CP，116例有MABC-2评分。早期（B：-1.92；p≤0.001）和足月（B：-1.67；p≤0.01）GBAS与MABC-2评分呈负相关。早期和足月GBAS在预测MABC-2≤第5百分位数时均具有高特异性（Sp）和低敏感性（Se）（早期：Se 36%，Sp 82%；足月：Se 28%，Sp 93%），在预测CP时具有高Se和Sp（早期：Se 78%，Sp 78%；足月：Se 75%，Sp 89%）。
早期和足月MRI对MABC-2结局的高Sp可能有助于准确识别6岁CA时不太可能出现运动障碍的婴儿。
