Rath CP, Desai S, Rao SC, Patole S. Diffuse excessive high signal intensity on term equivalent MRI does not predict disability: a systematic review and meta-analysis.
Arch Dis Child Fetal Neonatal Ed 2021;
106:9-16. [PMID:
32451357 DOI:
10.1136/archdischild-2019-318207]
[Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 03/25/2020] [Accepted: 04/22/2020] [Indexed: 02/01/2023]
Abstract
OBJECTIVE
To evaluate whether diffuse excessive high signal intensity (DEHSI) on term equivalent age MRI (TEA-MRI) predicts disability in preterm infants.
DESIGN
This is a systematic review and meta-analysis. Medline, EMBASE, Cochrane Library, EMCARE, Google Scholar and MedNar databases were searched in July 2019. Studies comparing developmental outcomes of isolated DEHSI on TEA-MRI versus normal TEA-MRI were included. Two reviewers independently extracted data and assessed the risk of bias. Meta-analysis was undertaken where data were available in a format suitable for pooling.
MAIN OUTCOME MEASURES
Neurodevelopmental outcomes ≥1 year of corrected age based on validated tools.
RESULTS
A total of 15 studies (n=1832) were included, of which data from 9 studies were available for meta-analysis. The pooled estimate (n=7) for sensitivity of DEHSI in predicting cognitive/mental disability was 0.58 (95% CI 0.34 to 0.79) and for specificity was 0.46 (95% CI 0.20 to 0.74). The summary area under the receiver operating characteristics (ROC) curve was low at 0.54 (CI 0.50 to 0.58). A pooled diagnostic OR (DOR) of 1 indicated that DEHSI does not discriminate preterm infants with and without mental disability. The pooled estimate (n=8) for sensitivity of DEHSI in predicting cerebral palsy (CP) was 0.57 (95% CI 0.37 to 0.75) and for specificity was 0.41 (95% CI 0.24 to 0.62). The summary area under the ROC curve was low at 0.51 (CI 0.46 to 0.55). A pooled DOR of 1 indicated that DEHSI does not discriminate between preterm infants with and without CP.
CONCLUSIONS
DEHSI on TEA-MRI did not predict future development of cognitive/mental disabilities or CP.
PROSPERO REGISTRATION NUMBER
CRD42019130576.
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