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Pediatric Radiology
Published in: Pediatric Radiology 8/2010

01-08-2010 | Original Article

Appearances of diffuse excessive high signal intensity (DEHSI) on MR imaging following preterm birth

Authors: Anthony R. Hart, Michael F. Smith, Alan S. Rigby, Lauren I. Wallis, Elspeth H. Whitby

Published in: Pediatric Radiology | Issue 8/2010

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Abstract

Background

Diffuse damage to the periventricular white matter has recently been suggested to be a cause of the cognitive deficits seen following preterm birth. It is unclear whether this form of injury can be visualised on MR imaging, but one group has described diffuse excessive high signal intensity (DEHSI) as a possible form of diffuse white matter injury. This finding is dependant on window imaging and the subjective assessment of the reviewer, but little data have been published on the degree of subjectivity on its appearance among raters.

Objective

To assess the subjectivity of DEHSI on conventional and ultrafast T2-weighted MR imaging following preterm birth.

Materials and methods

An observational study of 40 preterm infants who had MR imaging of the brain around term-equivalent age, including conventional fast spin-echo (FSE) and ultrafast single-shot fast spin-echo (SSFSE) T2-weighted sequences in the axial plane. Images were anonymised and scored twice by four observers for the presence of DEHSI. Inter- and intra-observer agreement were calculated.

Results

Sixty-five percent of conventional and 100% of the ultrafast images were of diagnostic quality. DEHSI was noted in between 0% and 69.2% of conventional images and 27.5–90% of the ultrafast images. Inter- and intra-observer agreement ranged from none to moderate.

Conclusion

The visual appearances of DEHSI on conventional FSE and ultrafast SSFSE T2-W images are highly subjective, limiting its clinical application.
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Metadata
Title
Appearances of diffuse excessive high signal intensity (DEHSI) on MR imaging following preterm birth
Authors
Anthony R. Hart
Michael F. Smith
Alan S. Rigby
Lauren I. Wallis
Elspeth H. Whitby
Publication date
01-08-2010
Publisher
Springer-Verlag
Published in
Pediatric Radiology / Issue 8/2010
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-010-1633-7

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