The prognostic value of MRI-TEA in long-term outcomes of extreme prematurity -a scoping review

Abstract

Background- Survival of infants born EP (<32 weeks GA) is increasing due to advances in obstetrical practices and clinical management at the NICU. However, those infants still have long-term effects containing neurodevelopmental motor- and sensory impairments, and specific cognitive-, behavioural-, social- and emotional outcomes. Aims- This scoping review aims to appoint the paucities of current MRI studies and their correlations with neurodevelopmental outcomes. We also aim to discuss the relevance of 7T MRI and its capability in infant EP prognosis. Methods and procedures- A PubMed database screening has been performed. Studies have been removed based on our exclusion criteria by screening the title and abstracts first. After this, the remaining full text articles were again screened on the exclusion criteria. Lastly, articles were manually added after a manual search to provide background information on premature-related brain injuries and prognostic biomarkers of MRI on long-term outcomes. Outcomes and results- we identified 23 peer-reviewed articles, most (n= 17) were published between 2019 and 2022. A wide variety of variables like MRI sequences, MRI scoring systems, neurodevelopmental tests and the age of test administer were found. A general conclusion of the outcomes and the MRI prognostic biomarkers is provided, highlighting the paucities of 1.5T- and 3T MRI studies and the advantages of 7T MRI. Conclusion and implications- 1.5T- and 3T MRI studies predict motor- and severe cognitive outcome, however those studies lack in subtle or moderate findings, other neurodevelopmental outcomes or metabolic- and pathophysiological findings. 7T MRI would be relevant because spatial and spectral resolution increases, while the acquisition time remains the same. 7T MRITEA techniques as T2WI, SWI, PC-MRA, ihMT and MRS could reveal more prognostic biomarkers associated with long-term outcomes.