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Updated: Jun 16, 2026
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
White matter changes in extremely preterm infants, a population-based diffusion tensor imaging study
Béatrice Skiöld1, Sandra Horsch, Boubou Hallberg
1Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden. beatrice.skiold@karolinska.se
Insights
Extremely preterm infants often show diffuse and excessive high signal intensities (DEHSI) on MRI, indicating altered white matter organization, even without severe abnormalities. This highlights the need for advanced imaging in preterm infant brain assessment.
Area of Science:
- Neuroimaging
- Neonatal Neurology
- Developmental Neuroscience
Background:
- Extremely preterm birth poses risks for cerebral white matter (WM) development.
- Diffuse and excessive high signal intensities (DEHSI) are a specific MRI finding in preterm infants.
- Understanding WM abnormalities and DEHSI is crucial for assessing neurodevelopmental outcomes.
Purpose of the Study:
- To investigate cerebral white matter (WM) abnormalities and diffuse and excessive high signal intensities (DEHSI) in extremely preterm infants.
- To utilize magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) for detailed brain analysis.
- To compare findings in preterm infants with term-born healthy controls.
Main Methods:
- MRI and DTI were performed at term-equivalent age in a cohort of extremely preterm infants.
- Diffusion parameters, including Fractional Anisotropy (FA) and Apparent Diffusion Coefficient (ADC), were analyzed.
- Data from 109 preterm infants and 16 healthy term-born controls were compared.
Main Results:
- 14% of preterm infants exhibited moderate to severe WM abnormalities; 86% had mild or no abnormalities.
- DEHSI were prevalent, found in 56% of infants across all WM abnormality grades.
- Infants with WM abnormalities or DEHSI showed altered diffusion (lower FA, higher ADC) in the centrum semiovale compared to controls.
Conclusions:
- While moderate/severe WM abnormalities were less common (14%), DEHSI incidence was high in extremely preterm infants.
- Altered diffusion parameters in DEHSI regions suggest underlying changes in white matter organization.
- DTI reveals subtle WM alterations in preterm infants that may not be apparent on conventional MRI.
Aim:
To investigate cerebral white matter (WM) abnormalities (J Pediatr 2003; 143: 171) and diffuse and excessive high signal intensities (DEHSI), (J Pediatr 1999; 135: 351) in a cohort of extremely preterm infants born in Stockholm during a 3-year period, using magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI).
Methods:
MRI at term-equivalent age was performed in 109 infants and DTI data were acquired in 54 infants. Survival rate in the entire cohort was 67%. Sixteen term-born healthy control infants were scanned for comparison.
Results:
No or mild WM abnormalities were seen in 86% of infants and 14% had moderate or severe WM abnormalities. DEHSI were seen in infants with all grades of white matter abnormalities and were present in 56% of infants. In the WM at the level of centrum semiovale, infants with any WM abnormalities or DEHSI had lower Fractional Anisotropy and higher Apparent Diffusion Coefficient compared with control infants. No significant differences in diffusion were seen in infants without DEHSI compared with the controls in this region. Compared with controls, the preterm infants had significantly altered diffusion in the corpus callosum.
Conclusion:
Only 14% of the extremely preterm infants had moderate or severe WM abnormalities on MRI. However, the incidence of DEHSI was high. In the DEHSI regions, changes in diffusion parameters were detected, indicating altered WM organization.
