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VOLUME 2 , ISSUE 2 ( April-June, 2023 ) > List of Articles

ORIGINAL RESEARCH

Imaging of the Preterm Cerebellum

Pavan Kalamdani, Gayatri Athalye-Jape, Saumil Desai, Nalinikanta Panigrahy, Ju-Li Ang, Amit Upadhyay, Roya Huseynova, Ogtay Huseynov, Anil Rao, Thierry AGM Huisman

Keywords : Cerebellar hemorrhage, Cerebellum, Diagnostic imaging, Disruptions, Magnetic resonance imaging, Malformations

Citation Information : Kalamdani P, Athalye-Jape G, Desai S, Panigrahy N, Ang J, Upadhyay A, Huseynova R, Huseynov O, Rao A, Huisman TA. Imaging of the Preterm Cerebellum. 2023; 2 (2):115-121.

DOI: 10.5005/jp-journals-11002-0061

License: CC BY-NC 4.0

Published Online: 05-07-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Cerebellar injury is being increasingly recognized as a significant complication of preterm birth. A critical phase of cerebellar growth occurs during the third trimester characterized by cellular migration, proliferation, and arborization. This vulnerable developmental phase increases the risk of impaired cerebellar development, especially in preterm infants, given their exposure to adverse extrauterine environments. Cerebellar malformations and disruptions are the types of cerebellar insults encountered. A “malformation” is defined as a non-progressive, congenital morphologic anomaly of a single organ or body part following altered primary development. A “disruption” is defined as a non-progressive, congenital morphologic anomaly following the breakdown of a body structure that had the normal potential for development. Advances in neonatal neuroimaging with increased use of mastoidal and suboccipital views focusing on the posterior fossa by cranial ultrasound (cUS) and high-resolution anatomical and functional magnetic resonance imaging (MRI) have improved the sensitive and specific identification of posterior fossa abnormalities, in particular of cerebellar injury in preterm neonates. This article discusses the various modalities of neuroimaging of the cerebellum with advantages and disadvantages. Ultrasonography (USG) is the most easily available and feasible bedside modality of imaging, though it has the disadvantage of not detecting subtle abnormalities like punctate hemorrhages. Conventional T1 and T2 weighted MRI can detect most of the cerebellar malformations and disruptions in preterm infants. But the logistics of MRI at most institutions make it less feasible during the first few weeks of life for extremely preterm neonates. The role of advanced MRI modalities such as functional MRI, diffusion tensor imaging (DTI), and magnetic resonance (MR) spectroscopy in cerebellar disruptions and malformations are also discussed in some detail.


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