1. Neonatal Meningitis: Magnetic-resonance-imaging-based Scores Analysis in Preterm and Term Newborns Department of Radiology, Children Hospital of Fudan University, Shanghai 201102, China ASNR 2015, Chicago, USA EP-123 Mingshu Yang, Zhongwei Qiao

2. Disclosures  I have no disclosure 2ASNR 53rd Annual Meeting, 2015, Chicago, USA. EP-123

3. Purpose  To describe the magnetic resonance imaging (MRI) patterns of brain damage in neonatal meningitis and to investigate the difference between preterm and term newborn by using MRI-based score analysis 3ASNR 53rd Annual Meeting, 2015, Chicago, USA. EP-123

4. Materials and Methods (1)  65 newborns with meningitis  18 preterms  47 terms  clinical information  MRI dataset 4ASNR 53rd Annual Meeting, 2015, Chicago, USA. EP-123

5. Materials and Methods (2) ItemsMRI AbnormalitiesScore 1Score 2Score 3 1Ventricular dilatation # NegativeMildModerate, or severe 2Periventricular white matter volume lossNegativePositive/ 3Cystic abnormalityNegativeFocalExtensive 4 Abnormal myelination of the posterior limb of the internal capsule Negative Positive at corrected age ≥37 wk / 5Cortical gray matter signal abnormalityNegativeFocal≥ 2 lesions, or extensive 6Intracranial extracerebral space abnormalityNegativeFocal≥ 2 lesions, or extensive 7Basal ganglia signal abnormalityNegativeFocal≥ 2 lesions, or extensive 8Non-cystic white matter signal abnormality $ NegativeMildModerate, or severe 9Intraventricular hemorrhageNegativeGrade I, Grade IIGrade III, or Grade IV 10PyocephalusNegativeFocal≥ 2 lesions, or extensive 11Abnormal meningeal enhancementNegativeFocal≥ 2 lesions, or extensive 12Abnormal ependymal enhancementNegativeFocalExtensive 13EncephalopyosisNegativeFocal and diameter < 3 cm Extensive or diameter ≥3 cm Table 1 The brain abnormalities identified on MRI and MRI-based grading scores 5ASNR 53rd Annual Meeting, 2015, Chicago, USA. EP-123

6. Materials and Methods (3)  These 13 patterns were classified into three groups  White matter abnormalities (WMA)  Gray matter abnormalities (GMA)  Non-parenchyma abnormalities (NPA) 6ASNR 53rd Annual Meeting, 2015, Chicago, USA. EP-123

7. Results (1) Fig. 1 The brain regions involved by meningitis in newborns observed on magnetic resonance imaging (MRI). There were 60% (39/65) patients showed lesions in cerebra, 3% (2/65) in cerebra and cerebella, 2% (1/65) in brain stems, but 35% (23/65) did not demonstrate any abnormalities on MRI. 7ASNR 53rd Annual Meeting, 2015, Chicago, USA. EP-123

8. Results (2) Fig. 2 & 3 The frequencies and MRI-based scores of abnormal myelination of the posterior limb of internal capsules, ventricular dilatation and periventricular white matter volume loss were higher in the preterm than the term. 8ASNR 53rd Annual Meeting, 2015, Chicago, USA. EP-123

9. Results (3) Fig. 4 Regarding the WMA, GMA and NPA, the score of WMA in the preterm was significantly higher than that of the term (p =.000). While the differences of GMA and NPA scores between the preterm and the term were not significant (p =.076,.224, respectively). 9ASNR 53rd Annual Meeting, 2015, Chicago, USA. EP-123

10. Conclusions The preterm neonates with meningitis were inclined to have white matter abnormalities and resulted in much more severe brain damages than the term ones 10ASNR 53rd Annual Meeting, 2015, Chicago, USA. EP-123

11. References 1.Woodward LJ, Anderson PJ, Austin NC, Howard K, Inder TE. Neonatal MRI to predict neurodevelopmental outcomes in preterm infants. N Engl J Med 2006;355:685. 2.Diffusion-weighted MR imaging of subdural empyemas in children. AJNR Am J Neuroradiol 2004;25:1016. 3.Mohan S, Jain KK, Arabi M, Shah GV. Imaging of meningitis and ventriculitis. Neuroimaging Clin N Am 2012;22:557. 4.Shah DK, Daley AJ, Hunt RW, Volpe JJ, Inder TE. Cerebral white matter injury in the newborn following Escherichia coli meningitis. Eur J Paediatr Neurol 2005;9:13. 5.Stoll BJ, Hansen NI, Adams-Chapman I, Fanaroff AA, Hintz SR, Vohr B, Higgins RD. Neurodevelopmental and growth impairment among extremely low-birth-weight infants with neonatal infection. JAMA 2004;292:2357. 11ASNR 53rd Annual Meeting, 2015, Chicago, USA. EP-123

12. Thank you for your attention! Acknowledge Dr. Li Wang & Mingshu Yang Children Hospital of Fudan University Shanghai, China 12ASNR 53rd Annual Meeting, 2015, Chicago, USA. EP-123