X Ou1, C M Glasier2, R H Ramakrishnaiah2, S B Mulkey3, Z Ding4, T L Angtuaco5, A Andres6, J R Kaiser7. 1. From the Department of Radiology (X.O., C.M.G., R.H.R., T.L.A.), University of Arkansas for Medical Sciences, Little Rock, Arkansas Pediatric Radiology (X.O., C.M.G., R.H.R.), Arkansas Children's Hospital, Little Rock, Arkansas ouxiawei@uams.edu. 2. From the Department of Radiology (X.O., C.M.G., R.H.R., T.L.A.), University of Arkansas for Medical Sciences, Little Rock, Arkansas Pediatric Radiology (X.O., C.M.G., R.H.R.), Arkansas Children's Hospital, Little Rock, Arkansas. 3. Departments Pediatrics (S.B.M., A.A.). 4. Vanderbilt University Institute of Imaging Sciences (Z.D.), Nashville, Tennessee. 5. From the Department of Radiology (X.O., C.M.G., R.H.R., T.L.A.), University of Arkansas for Medical Sciences, Little Rock, Arkansas. 6. Departments Pediatrics (S.B.M., A.A.) Arkansas Children's Nutrition Center (A.A.), Little Rock, Arkansas. 7. Departments of Pediatrics and Obstetrics and Gynecology, Section of Neonatology (J.R.K.), Baylor College of Medicine, Texas Children's Hospital, Houston, Texas.
Abstract
BACKGROUND AND PURPOSE: Brain hemorrhage is common in premature infants. The purpose of the study is to evaluate white matter development in extremely low-birth-weight infants with or without previous brain hemorrhage. MATERIALS AND METHODS: Thirty-three extremely low-birth-weight infants were prospectively enrolled and included in this institutional review board-approved study. Another 10 healthy term infants were included as controls. The medical records of the extremely low-birth-weight infants were reviewed for sonography diagnosis of intraventricular hemorrhage. All infants had an MR imaging examination at term-equivalent age for detection of previous hemorrhage, and their white matter was scored and compared among different groups. DTI measured fractional anisotropy values were also compared voxelwise by tract-based spatial statistics. RESULTS: Compared with controls, the white matter score was not significantly different in extremely low-birth-weight infants without blood deposition on MR imaging (P = .17), but was significantly worse in extremely low-birth-weight infants with blood deposition on MR imaging but no intraventricular hemorrhage diagnosis by sonography (P = .02), in extremely low-birth-weight infants with grade 1 or 2 intraventricular hemorrhage on sonography (P = .003), and in extremely low-birth-weight infants with grade 3 or 4 intraventricular hemorrhage on sonography (P = .0001). Extremely low-birth-weight infants without blood deposition on MR imaging did not show any white matter regions with significantly lower fractional anisotropy values than controls. Extremely low-birth-weight infants with blood deposition on MR imaging, but no intraventricular hemorrhage diagnosis, did show white matter regions with significantly lower fractional anisotropy values, and extremely low-birth-weight infants with intraventricular hemorrhage diagnosis had widespread white matter regions with lower fractional anisotropy values. CONCLUSIONS: Previous brain hemorrhage is associated with abnormal white matter in extremely low-birth-weight infants at term-equivalent age, and sonography is not sensitive to minor hemorrhages that are sufficient to cause white matter injury.
BACKGROUND AND PURPOSE:Brain hemorrhage is common in premature infants. The purpose of the study is to evaluate white matter development in extremely low-birth-weight infants with or without previous brain hemorrhage. MATERIALS AND METHODS: Thirty-three extremely low-birth-weight infants were prospectively enrolled and included in this institutional review board-approved study. Another 10 healthy term infants were included as controls. The medical records of the extremely low-birth-weight infants were reviewed for sonography diagnosis of intraventricular hemorrhage. All infants had an MR imaging examination at term-equivalent age for detection of previous hemorrhage, and their white matter was scored and compared among different groups. DTI measured fractional anisotropy values were also compared voxelwise by tract-based spatial statistics. RESULTS: Compared with controls, the white matter score was not significantly different in extremely low-birth-weight infants without blood deposition on MR imaging (P = .17), but was significantly worse in extremely low-birth-weight infants with blood deposition on MR imaging but no intraventricular hemorrhage diagnosis by sonography (P = .02), in extremely low-birth-weight infants with grade 1 or 2 intraventricular hemorrhage on sonography (P = .003), and in extremely low-birth-weight infants with grade 3 or 4 intraventricular hemorrhage on sonography (P = .0001). Extremely low-birth-weight infants without blood deposition on MR imaging did not show any white matter regions with significantly lower fractional anisotropy values than controls. Extremely low-birth-weight infants with blood deposition on MR imaging, but no intraventricular hemorrhage diagnosis, did show white matter regions with significantly lower fractional anisotropy values, and extremely low-birth-weight infants with intraventricular hemorrhage diagnosis had widespread white matter regions with lower fractional anisotropy values. CONCLUSIONS: Previous brain hemorrhage is associated with abnormal white matter in extremely low-birth-weight infants at term-equivalent age, and sonography is not sensitive to minor hemorrhages that are sufficient to cause white matter injury.
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