196 Improved Detection of Intracranial Hemorrhage in Term and Preterm Neonates Using Susceptibility Weighted Imaging

Background and aims Magnetic resonance imaging (MRI) at term age has been reported to be superior to cranial ultrasound (cUS) in detecting white matter abnormalities. The aim of this retrospective study was to compare sensitivity of MRI using SWI (susceptibility weighted imaging) and cUS in the detection of intracranial hemorrhage. Methods 68 consecutive term and preterm neonates, who received 3 Tesla MRI of the brain with SWI (Magnetom Skyra, Siemens Healthcare, Erlangen, Germany) around term and serial cUS (Acuson sequoia 512, Siemens Healthcare) during neonatal care, were included in this study between 05/2011 and 02/2012. MRI was performed using a MR-compatible incubator with compatible head coil (LMT nomag, Luebeck, Germany) under sedation. MRI were analyzed by two radiologists independently. Inter-rater agreement was estimated by Cohen’s kappa coefficient. Results MRI and cUS were feasible in all 68 neonates (38 girls, 30 boys, mean gestational age at birth 31.9±4.5 weeks (range 23.3–40.7 weeks). MR imaging was done at 40.3±3.0 weeks (range 30.7–55.7 weeks). Both radiologists independently identified (post-)hemorrhagic alterations in 20 of 68 infants by SWI (inter-rater agreement: K=1). In 10 this was in agreement with cUS, but in 4 of them additional intraventricular and/or parenchymal hemorrhagic components were diagnosed by MRI. All patients with suspected intracranial hemorrhage by cUS were confirmed by SWI. Conclusions We found improved detection of intracranial hemorrhage with high inter-rater agreement by MRI using SWI compared to cUS in term and preterm infants. All hemorrhages diagnosed by cUS could be confirmed by MRI.