Article Figures & Data
Figures
- Fig 1.
Coronal T2 (A) and axial T1 FLAIR (B), T2 (C), and SWI (D) MR images of a 6-day-old boy. Global severity score = 3 (first quartile) (E). There is diffuse bilateral WM signal abnormality of cerebral edema without infarction (3 points) (A and B). The DMVs are prominent bilaterally, seen on T2 (C) and SWI (D) (ovals). No WM lesions are visible. R indicates right; L, left.
- Fig 2.
Coronal T2 (A), axial T1 (B), ADC (C and D), and SWI (E and F) MR images of a 7-day-old girl. Global severity score = 10 (second quartile) (G). There is diffuse bilateral WM cerebral edema (3 points) (A and B) and multiple acute bilateral, asymmetric (left > right) hemorrhagic WM lesions (T1 bright and T2 dark) without restricted diffusion (C–F). On the right, there are mild punctate lesions in the frontal (1 point), parietal (1 point), and occipital WM (1 point, not shown) (E and F, boxes), and on the left, there are moderate punctate lesions in the frontal (2 points) and parietal WM (2 points) (E and F, circles). No corpus callosum or temporal region WM lesions are visible. R indicates right; L, left.
- Fig 3.
Coronal T2 (A) and axial TI FLAIR (B), ADC (C), and T2 (D) MR images of a 21-day-old boy. Global severity score = 22 (third quartile) (E). There is diffuse bilateral WM cerebral edema (3 points) (A–D) and multiple acute bilateral symmetric hemorrhagic WM lesions (T1 bright and T2 dark): frontal (moderate punctate, 2 points, and severe linear, 3 points) (A, boxes), parietal (moderate punctate, 2 points) (D, circles), and temporal regions (moderate punctate, 2 points, not shown). There are no visible occipital WM lesions. R indicates right; L, left.
- Fig 4.
Coronal T2 (A) and sagittal T1 (B), axial T2 (C), and axial ADC (D and E) MR images of a 12-day-old boy. Global severity score = 43 (fourth quartile) (F). There is diffuse bilateral WM cerebral edema (3 points) and multiple bilateral hemorrhagic WM lesions with restricted diffusion (A–F). There are symmetric bilateral frontal and parietal lesions: severe linear lesions (3 points; C, boxes) and severe cavitary lesions with restricted diffusion (6 points; A, B, and D, ovals), There are bilateral temporal lesions: right (mild punctate, 1 point) and left (moderate punctate, 2 points, not shown). There is restricted diffusion throughout the corpus callosum (3 points, E). No occipital WM lesions are visible. R indicates right; L, left.
Tables
Points Scoring Cerebral edema 0–3 None = 0, right or left = 1, bilateral asymmetric = 2, bilateral symmetric = 3 Corpus callosum 0–3 1 point each for genu, body, and/or splenium lesion Right cerebral WM Score each cerebral hemisphere region for punctate, linear, and/or cavitary lesions Frontal 0–12 Punctate: mild (1–3 lesions) = 1, moderate (4–6 lesions) = 2, severe (>6 lesions) = 3 Parietal 0–12 Linear: mild (1–3 lesions) = 1, moderate (4–6 lesions) = 2, severe (>6 lesions) = 3 Occipital 0–12 Cavitary: mild (1–3 lesions, <15 mm) = 2, moderate (4–6 lesions, <15 mm) = 4 Temporal 0–12 severe (>6 lesions, <15 mm, or 1+ lesion >15 mm) = 6 Left cerebral WM Frontal 0–12 Parietal 0–12 Occipital 0–12 Temporal 0–12 0–102 Global severity score Region Score 0 Score 1 Score 2 Score 3 P Value WM cerebral edema 4 (8) 2 (4) 9 (18) 36 (71) .52 Corpus callosum 26 (51) 10 (20) 8 (16) 7 (14) <.001 ↵a Data are number of patients (%).
Region Score 0–2 Score 3–5 Score 6–8 Score ≥9 P Value Right frontal 24 (47) 14 (28) 8 (16) 5 (10) <.001 Right parietal 33 (65) 8 (16) 9 (18) 1 (2) <.001 Right occipital 50 (98) 1 (2) 0 (0) 0 (0) .68 Right temporal 43 (84) 6 (12) 2 (4) 0 (0) .006 Left frontal 31 (61) 10 (20) 7 (14) 3 (6) <.001 Left parietal 37 (73) 5 (10) 7 (14) 2 (4) <.001 Left occipital 49 (96) 0 (0) 2 (4) 0 (0) .67 Left temporal 43 (84) 7 (14) 1 (2) 0 (0) <.001 ↵a Data are number of patients (%).
1st Quartile (Score = 1–5) (n = 14) 2nd Quartile (Score = 6–11) (n = 13) 3rd Quartile (Score = 12–25) (n = 12) 4th Quartile (Score ≥ 26) (n = 12) P Value Gestation at birth (wk) 38.2 ± 1.3 36.3 ± 2.4 36.7 ± 2.5 38 ± 1.9 .05d Birth weight (g) 3445.8 ± 618 3066 ± 989 2947 ± 619 3247 ± 570 .34d Male sex 8 (57) 8 (62) 9 (75) 7 (58) .87e 5-Minute Apgar 7.8 ± 1.6 7.9 ± 1.4 8 ± 1.5 7.4 ± 2.4 .92d Compressions/epinephrineb 1 (7) 0 (0) 0 (0) 1 (8) .97e Chorioamnionitis 0 (0) 0 (0) 0 (0) 1 (8) .98e Small for gestational age 0 (0) 2 (15) 3 (25) 2 (17) .75e Neonatal infectionc 1 (7) 2 (15) 3 (25) 3 (25) .84e Ventilator requirement 2 (14) 7 (54) 6 (50) 7 (58) .18e Inotrope use 0 (0) 3 (23) 2 (17) 4 (33) .52e Seizures 7 (50) 5 (38) 6 (50) 10 (83) .25e ↵a Data are mean or number (%).
↵b Compressions or epinephrine or both were given in the delivery room during resuscitation.
↵c Neonatal infection is defined as systemic/serious infection in the first week of life.
↵d The ANOVA was used to measure variance in means among 4 quartiles in continuous variables.
↵e The Kruskal-Wallis test was used for frequency distribution of categoric variables.
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