Assessment of Brain Injury and Brain Volumes after Posthemorrhagic Ventricular Dilatation : A Nested Substudy of the Randomized Controlled ELVIS Trial
(2019) In Journal of Pediatrics 208. p.2-197- Abstract
OBJECTIVE: To compare the effect of early and late intervention for posthemorrhagic ventricular dilatation on additional brain injury and ventricular volume using term-equivalent age-MRI.
STUDY DESIGN: In the Early vs Late Ventricular Intervention Study (ELVIS) trial, 126 preterm infants ≤34 weeks of gestation with posthemorrhagic ventricular dilatation were randomized to low-threshold (ventricular index >p97 and anterior horn width >6 mm) or high-threshold (ventricular index >p97 + 4 mm and anterior horn width >10 mm) groups. In 88 of those (80%) with a term-equivalent age-MRI, the Kidokoro Global Brain Abnormality Score and the frontal and occipital horn ratio were measured. Automatic segmentation was used for... (More)
OBJECTIVE: To compare the effect of early and late intervention for posthemorrhagic ventricular dilatation on additional brain injury and ventricular volume using term-equivalent age-MRI.
STUDY DESIGN: In the Early vs Late Ventricular Intervention Study (ELVIS) trial, 126 preterm infants ≤34 weeks of gestation with posthemorrhagic ventricular dilatation were randomized to low-threshold (ventricular index >p97 and anterior horn width >6 mm) or high-threshold (ventricular index >p97 + 4 mm and anterior horn width >10 mm) groups. In 88 of those (80%) with a term-equivalent age-MRI, the Kidokoro Global Brain Abnormality Score and the frontal and occipital horn ratio were measured. Automatic segmentation was used for volumetric analysis.
RESULTS: The total Kidokoro score of the infants in the low-threshold group (n = 44) was lower than in the high-threshold group (n = 44; median, 8 [IQR, 5-12] vs median 12 [IQR, 9-17], respectively; P < .001). More infants in the low-threshold group had a normal or mildly increased score vs more infants in the high-threshold group with a moderately or severely increased score (46% vs 11% and 89% vs 54%, respectively; P = .002). The frontal and occipital horn ratio was lower in the low-threshold group (median, 0.42 [IQR, 0.34-0.63]) than the high-threshold group (median 0.48 [IQR, 0.37-0.68], respectively; P = .001). Ventricular cerebrospinal fluid volumes could be calculated in 47 infants and were smaller in the low-threshold group (P = .03).
CONCLUSIONS: More brain injury and larger ventricular volumes were demonstrated in the high vs the low-threshold group. These results support the positive effects of early intervention for posthemorrhagic ventricular dilatation.
TRIAL REGISTRATION: ISRCTN43171322.
(Less)
- author
- contributor
- Ley, David LU and Fellman, Vineta LU
- author collaboration
- organization
- publishing date
- 2019-05
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Brain/diagnostic imaging, Brain Injuries/diagnostic imaging, Cerebral Hemorrhage/diagnostic imaging, Cerebral Ventricles/diagnostic imaging, Cerebrospinal Fluid, Cerebrospinal Fluid Shunts, Dilatation, Female, Humans, Hydrocephalus/diagnostic imaging, Infant, Newborn, Infant, Premature, Infant, Premature, Diseases/diagnostic imaging, Intracranial Hemorrhages/diagnostic imaging, Magnetic Resonance Imaging, Male, White Matter/diagnostic imaging
- in
- Journal of Pediatrics
- volume
- 208
- pages
- 2 - 197
- publisher
- Academic Press
- external identifiers
-
- scopus:85062713479
- pmid:30878207
- ISSN
- 1097-6833
- DOI
- 10.1016/j.jpeds.2018.12.062
- language
- English
- LU publication?
- yes
- additional info
- Copyright © 2019 Elsevier Inc. All rights reserved.
- id
- 9b88ec94-2d70-4cb9-be62-3af044767dd1
- date added to LUP
- 2023-10-19 12:22:12
- date last changed
- 2024-04-19 02:36:05
@article{9b88ec94-2d70-4cb9-be62-3af044767dd1, abstract = {{<p>OBJECTIVE: To compare the effect of early and late intervention for posthemorrhagic ventricular dilatation on additional brain injury and ventricular volume using term-equivalent age-MRI.</p><p>STUDY DESIGN: In the Early vs Late Ventricular Intervention Study (ELVIS) trial, 126 preterm infants ≤34 weeks of gestation with posthemorrhagic ventricular dilatation were randomized to low-threshold (ventricular index >p97 and anterior horn width >6 mm) or high-threshold (ventricular index >p97 + 4 mm and anterior horn width >10 mm) groups. In 88 of those (80%) with a term-equivalent age-MRI, the Kidokoro Global Brain Abnormality Score and the frontal and occipital horn ratio were measured. Automatic segmentation was used for volumetric analysis.</p><p>RESULTS: The total Kidokoro score of the infants in the low-threshold group (n = 44) was lower than in the high-threshold group (n = 44; median, 8 [IQR, 5-12] vs median 12 [IQR, 9-17], respectively; P < .001). More infants in the low-threshold group had a normal or mildly increased score vs more infants in the high-threshold group with a moderately or severely increased score (46% vs 11% and 89% vs 54%, respectively; P = .002). The frontal and occipital horn ratio was lower in the low-threshold group (median, 0.42 [IQR, 0.34-0.63]) than the high-threshold group (median 0.48 [IQR, 0.37-0.68], respectively; P = .001). Ventricular cerebrospinal fluid volumes could be calculated in 47 infants and were smaller in the low-threshold group (P = .03).</p><p>CONCLUSIONS: More brain injury and larger ventricular volumes were demonstrated in the high vs the low-threshold group. These results support the positive effects of early intervention for posthemorrhagic ventricular dilatation.</p><p>TRIAL REGISTRATION: ISRCTN43171322.</p>}}, author = {{Cizmeci, Mehmet N and Khalili, Nadieh and Claessens, Nathalie H P and Groenendaal, Floris and Liem, Kian D and Heep, Axel and Benavente-Fernández, Isabel and van Straaten, Henrica L M and van Wezel-Meijler, Gerda and Steggerda, Sylke J and Dudink, Jeroen and Išgum, Ivana and Whitelaw, Andrew and Benders, Manon J N L and de Vries, Linda S}}, issn = {{1097-6833}}, keywords = {{Brain/diagnostic imaging; Brain Injuries/diagnostic imaging; Cerebral Hemorrhage/diagnostic imaging; Cerebral Ventricles/diagnostic imaging; Cerebrospinal Fluid; Cerebrospinal Fluid Shunts; Dilatation; Female; Humans; Hydrocephalus/diagnostic imaging; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases/diagnostic imaging; Intracranial Hemorrhages/diagnostic imaging; Magnetic Resonance Imaging; Male; White Matter/diagnostic imaging}}, language = {{eng}}, pages = {{2--197}}, publisher = {{Academic Press}}, series = {{Journal of Pediatrics}}, title = {{Assessment of Brain Injury and Brain Volumes after Posthemorrhagic Ventricular Dilatation : A Nested Substudy of the Randomized Controlled ELVIS Trial}}, url = {{http://dx.doi.org/10.1016/j.jpeds.2018.12.062}}, doi = {{10.1016/j.jpeds.2018.12.062}}, volume = {{208}}, year = {{2019}}, }