Serial cUS scans were performed by a team of experienced sonographers who have worked more than 5 years, using an Mindray M5 scanner (Shenzhen) with a special standardized preset in accordance with the standard protocol: scanning with a transducer frequency of 8 MHz within 48 hours of birth, and scanning weekly during admission until discharge or TEA and again monthly until 6 months or elder. Most scans were done beside bed.

PVE were defined and classified in reference to van Wezel–Meijler et al.[4] Cerebral hemorrhages were classified in accordance with the Papile standard.[5] Hydrocephaly grades were classified into 3 degrees on the basis of ventricular index and in accordance with Lara et al mild hydrocephaly- less than 13 mm; moderate hydrocephaly- 13 to 15 mm, and severe hydrocephaly- more than 15 mm.[5] Weekly and monthly ultrasonic reports of the infants were obtained for brain injury classification. Images of the first cUS, TEA-cUS, and last cUS were reviewed blindly by 2 doctors and classified to 3 degrees in accordance with PVE grade, hydrocephaly degree, cystic periventricular leukomalacias (c-PVL) and hemorrhage grade of the Papile standard.

Normal/mild injury: no PVE or homogeneous PVE-I.

Moderate injury: PVE-II (regardless of appearance and duration), or accompanied by germinal matrix hemorrhage (GMH) degree 1 to 2 or single choroid plexus.

Severe injury: PVE-III or accompanied by GMH degrees 3 to 4.

Normal/mild injury: mild hydrocephaly and/or less than 2 local c-PVLs.

Moderate injury: moderate hydrocephaly or more than 2 local c-PVLs.

Severe injury: severe hydrocephaly or extensive c-PVLs.

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