Value of susceptibility weighted imaging in the diagnosis of neonatal intracranial hemorrhage and the hemorrhagic difference between preterm and term neonates

Objective To investigate the value of susceptibility weighted imaging (SWI) in the diagnosis of infants with intracranial hemorrhage (ICH) and the hemorrhagic difference between preterm and term neonates. Methods One hundred and fifteen cases of suspected brain injury underwent conventional MRI,DWI and SWI to determine whether they had ICH and record the numbers of each hemorrhagic lesion.The detecting rate,distribution and number of ICH were compared among these methods,and the distribution and number of ICH were compared between preterm and term neonates. Results SWI had a higher detection rate than conventional MRI and DWI (the detection rate was 32.2%,26.1% and 12.2%,respectively P<0.05) and conventional MRI also had a higher detection rate than DWI (P<0.05).Of the 37 cases of ICH,conventional MRI,DWI and SWI detected 66,33,125 hemorrhagic lesions respectively.More hemorrhagic lesions were found on SWI than conventional MRI and DWI (all P value<0.05),and more lesions were showed on conventional MRI than DWI (t=4.932,P<0.05).Hemorrhagic lesions mainly located at germinal matrix-ventricle,cerebrum and cerebellar hemispheres.SWI showed more hemorrhagic lesions than conventional MRI and DWI in these areas (all P value<0.05).SWI and conventional MRI detected more subarachnoid and subdural hemorrhage than DWI (P<0.05),but no difference was found between SWI and conventional MRI.Preterm infants had more hemorrhagic lesions than term infants (P<0.05),especially in the germinal matrix-ventricle (P<0.05).The numbers of hemorrhagic lesions were found no significant difference in other brain areas (P>0.05). Conclusion SWI is a better tool to detect neonatal ICH than conventional MRI and DWI.But differences can be found among these Methods when detecting ICH in different brain areas.The newborns with suspected ICH should undergo SWI,conventional MRI and DWI to make a comprehensive judgment whether they have ICH and the numbers of hemorrhagic lesions.Our Results provide important clues for clinical diagnosis,treatment and prognostic assessment of neonatal ICH.