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Purpose To measure cerebellar growth in a longitudinal cohort of very preterm infants to identify early predictors of subsequent brain growth. Although the cerebellum grows rapidly during late gestation, the rate and variability of growth following premature birth, and the effects of associated injury, are largely unknown. Materials and Methods In all, 105 very-preterm born infants (24–32 weeks GA) were imaged using magnetic resonance imaging (MRI) at birth, term-equivalent, 2, and 4 years of age. Cerebellar and total cerebral volumes were estimated from 1 mm isotropic T1-weighted scans acquired at 1.5T and 3T, using an atlas-based approach. Linear models were used to analyze cerebellar volume as cross-sectional and longitudinal functions of age, clinical, and radiological correlates. Linear models were also used to test for associations between volume and cognitive outcome. Results Cerebellar volume increased rapidly with age-at-scan during both the preterm (0.7 mL/wk, P < 0.001) and term periods (1.8 mL/wk, P < 0.001). Infants with grade 3 or 4 germinal matrix hemorrhage (GMH) had smaller cerebellar volumes as a percentage of total brain volume starting at birth and continuing to 4 years of age (–0.43%, –0.57%, –1.09% at preterm, term, and 4 years, respectively, P < 0.01). Irrespective of age-at-scan, early cerebellar volume was predictive of volume at 4 years of age (slope = 1.3, P < 0.001). Cerebellar volumes were not found to predict cognitive outcome at 4 years of age; P < 0.2. Conclusion High-grade GMH and small perinatal cerebellar size is predictive of cerebellar development up to 4 years of age. These findings suggest that it is possible to identify individuals at high risk of reduced cerebellar volumes at an early age. J. Magn. Reson. Imaging 2015.

Key Clinical Message Conjugated hyperbilirubinemia, posterior embryotoxon, and vertebral anomalies are not features of William syndrome (WS). We herein report a preterm infant who presented with features suggestive of Alagille syndrome, but microarray showed findings consistent with WS. This further extends the phenotype of WS and emphasizes the need for microarray analysis.

Aim The aim of this study was to determine the feasibility of undertaking visual functional magnetic resonance imaging (fMRI) in very preterm children. Method Forty-seven infants born at less than 32 weeks gestational age (25 males, 22 females; mean (SD) age at birth 28.8wks [1.9]) were scanned using 1.5T MRI as part of a longitudinal neuroimaging study. These infants were scanned at preterm age (within 2wks of birth) and at term-equivalent age. Quantitative T2* data and fMRI in response to visual stimuli (flashing strobe) were acquired in this population. T2* values were compared at preterm age and at term-equivalent age using a two-tailed t-test. A general linear model was used to evaluate occipital lobe response to visual stimuli. Results T2* values were significantly higher at preterm age than at term-equivalent age in both the medial and lateral occipital lobes (preterm infants: 187.2ms and 198.4ms respectively; term infants: 110.9ms and 133.2ms respectively; p

Summary. The North American literature was reviewed regarding the developmental outcome of infants treated with ECMO therapy versus those infants who received conventional medical therapy for treatment of persistent pulmonary hypertension of the newborn. The literature reviewed included all ECMO follow-up investigations published in medical journals cited in CD-ROM between January 1980 and July 1992, as well as abstracts presented at the Society for Pediatric Research 1990 — 1992. The literature was examined with respect to the incidence, prevalence and nature of morbidity, with particular attention paid to the neurodevelopmental domains assessed, test measures used, age at assessment and criteria for normal and abnormal outcome. Rough comparison of the published outcome statistics for the cohorts of infants who received neonatal ECMO therapy or conventional medical therapy (CMT) suggest equivalent amounts of morbidity within the first few years of life. Without appropriate systematic comparison at the same ages on the same measures and in infants with equivalent severity of illness, the current observations remain tentative at best. Longitudinal investigations are needed in order to identify specific medical and developmental markers in infancy of good and poor long-term outcome in this population, together with comparisons of outcome in the group treated with ECMO versus the group treated with CMT. Fine-grained, sensitive measures must be employed that record transient or permanent delays and/or qualitative deficits in specific skills.

Outcomes at 18-24 months corrected age of very low-birth-weight infants admitted to our Neonatal Intensive Care Unit in 1984-1987 (period 2) were compared with the outcomes of infants admitted in 1980-1983 (period 1) (total 1357 infants). In the 500-750-g birth-weight subgroup, the survival rate increased from 32 to 54% (p = 0.002). Rates of moderate and severe impairment at 18-24 months (neurosensory deficit, or Bayley corrected mental developmental index < or = 68) in this subgroup decreased from 41 to 15% (p = 0.005), and in those without severe impairment, mean mental Bayley scores in periods 1 and 2 were 84 +/- 18 and 90 +/- 16, respectively (p = 0.20). Analysis after exclusion of small-for-gestational-age infants gave similar results. In the small-for-gestational-age infants of birth weight 500-750 g, the survival rate increased but the impairment rate was unchanged between periods. It is concluded that outcomes improved in 1984-1987 compared with 1980-1983 only for infants with birth weight of 500-750 g.