Woodward et al developed scores for grading MRI changes in the brains of neonates with cerebral injury. These can help identify patients who may have more severe disease. The authors are from the University of Canterbury and Christchurch in New Zealand and the University of Melbourne in Australia.
Examination: MRI of the brain
White matter parameters:
(1) signal abnormality
(2) reduction in volume
(3) cystic change
(4) size of lateral ventricles
(5) corpus callosum and myelination
Gray matter parameters:
(1) subarachnoid space
(2) signal abnormality in the cortical gray matter
(3) gyral maturation
|
Parameter |
Finding |
Points |
|
signal abnormality |
nil |
1 |
|
|
focal (1 region only) |
2 |
|
|
2 or more regions |
3 |
|
reduction in volume |
normal |
1 |
|
|
mild to moderate loss |
2 |
|
|
diffuse, marked loss |
3 |
|
cystic abnormality |
nil |
1 |
|
|
focal |
2 |
|
|
extensive |
3 |
|
size of the lateral ventricles |
normal |
1 |
|
|
mild to moderate dilatation |
2 |
|
|
marked dilatation |
3 |
|
corpus callosum, myelination |
normal |
1 |
|
|
isolated partial thinning of the corpus callosum |
|
|
|
marked thinning of corpus callosum |
2 |
|
|
marked thinning of corpus callosum and marked delay in myelination |
3 |
|
Parameter |
Finding |
Points |
|
subarachnoid space |
normal |
1 |
|
|
mild enlargement |
2 |
|
|
moderate to severe enlargement |
3 |
|
signal abnormality in cortex |
nil |
1 |
|
|
focal (1 region only) |
2 |
|
|
2 or more regions |
3 |
|
gyral maturation |
normal for age |
1 |
|
|
delayed 2-4 weeks |
2 |
|
|
delayed > 4 weeks |
3 |
total white matter score =
= SUM(points for all 5 white matter parameters)
total gray matter score =
= SUM(points for all 3 gray matter parameters)
total composite score =
= (white matter score) + (gray matter score)
Interpretation:
• minimum white matter score: 5
• maximum white matter score: 15
• minimum gray matter score: 3
• maximum gray matter score: 9
• minimum composite score: 8
• maximum composite score: 24
|
Composite Score |
Abnormality |
|
8 – 10 |
none or minimal |
|
11 – 14 |
moderate |
|
15 – 24 |
severe |
Specialty: Neurology, Pedatrics
