Abstract
Objectives
To evaluate white matter (WM) microstructural changes in preterm neonates (PN) with mild germinal matrix-intraventricular haemorrhage (mGMH-IVH) (grades I and II) and no other associated MRI abnormalities, and correlate them with gestational age (GA) and neurodevelopmental outcome.
Methods
Tract-based spatial-statistics (TBSS) was performed on DTI of 103 patients studied at term-equivalent age, to compare diffusional parameters (fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), axial diffusivity (AD)) between mGMH-IVH neonates (24/103) and controls matched by GA at birth and sex. The relationship between DTI abnormalities, GA and neurodevelopmental outcome assessed with Griffiths’ Developmental Scale-Revised:0-2 was explored using TBSS and Spearman-correlation analysis (p < .05).
Results
Affected neonates had lower FA, higher RD and MD of the corpus callosum, limbic pathways and cerebellar tracts. Extremely preterm neonates (GA < 29 weeks) presented more severe microstructural impairment (higher RD and MD) in periventricular regions. Neonates of GA ≥ 29 weeks had milder WM alterations (lower FA), also in subcortical WM. DTI abnormalities were associated with poorer locomotor, eye-hand coordination and performance outcomes at 24 months.
Conclusions
WM microstructural changes occur in PN with mGMH-IVH with a GA-dependent selective vulnerability of WM regions, and correlate with adverse neurodevelopmental outcome at 24 months.
Key Points
• DTI-TBSS analysis identifies WM microstructural changes in preterm neonates with mGMH-IVH.
• Extremely preterm neonates with mGMH-IVH presented more severe impairment of WM microstructure.
• Extremely preterm neonates with mGMH-IVH presented microstructural impairment of periventricular WM.
• mGMH-IVH affects subcortical WM in preterm neonates with gestational age ≥ 29 weeks.
• WM microstructural alterations are related to neurodevelopmental impairments at 24 months.
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Abbreviations
- AD:
-
Axial diffusivity
- DTI:
-
Diffusion tensor imaging
- FA:
-
Fractional anisotropy
- GA:
-
Gestational age
- GMH-IVH:
-
Germinal matrix–intraventricular haemorrhage
- MD:
-
Mean diffusivity
- mGMH-IVH:
-
Mild Germinal matrix–intraventricular haemorrhage
- MRI:
-
Magnetic resonance imaging
- PN:
-
Preterm neonates
- RD:
-
Radial diffusivity
- TBSS:
-
Tract-based spatial-statistics
- WM:
-
White matter
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The scientific guarantor of this publication is Dr. Andrea Rossi.
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Written informed consent was provided by the parents of neonates.
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• retrospective
• case-control study
• performed at one institution
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Tortora, D., Martinetti, C., Severino, M. et al. The effects of mild germinal matrix-intraventricular haemorrhage on the developmental white matter microstructure of preterm neonates: a DTI study. Eur Radiol 28, 1157–1166 (2018). https://doi.org/10.1007/s00330-017-5060-0
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DOI: https://doi.org/10.1007/s00330-017-5060-0