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Quantitative fiber tracking in the corpus callosum and internal capsule reveals microstructural abnormalities in
C van Pul1, B J M van Kooij, L S de Vries
1Department of Neonatology, Wilhelmina Children's Hospital/University Medical Centre Utrecht, Utrecht, The Netherlands. c.vanpul@mmc.nl
Insights
Diffusion tensor imaging (DTI) reveals white matter injury (WMI) in preterm infants. Decreased anisotropy and increased diffusivity in the corpus callosum (CC) are linked to higher WMI scores, indicating impaired brain maturation.
Area of Science:
- Neuroimaging
- Developmental Neuroscience
- Pediatric Radiology
Background:
- Signal-intensity abnormalities in the posterior limb of the internal capsule (PLIC) and corpus callosum (CC) thinning are common in preterm infants and linked to poor outcomes.
- Diffusion tensor imaging (DTI) can detect subtle white matter abnormalities.
Purpose of the Study:
- To investigate the relationship between white matter injury (WMI) and microstructural properties of the CC and PLIC in preterm infants using DTI.
- To assess the impact of prematurity on brain development using fiber tractography (FT).
Main Methods:
- A prospective study of 120 preterm infants (<31 weeks' gestation) using 3T DTI.
- Quantitative analysis of CC and PLIC fiber bundles, including volume, length, anisotropy, and mean diffusivity (MD).
- General linear models assessed the effects of gestational age, birth weight, head circumference, postmenstrual age, and WMI on FT-segmented parameters.
Main Results:
- Increased WMI correlated with decreased fractional anisotropy (FA), bundle volume, and length in the CC.
- Increased MD was observed in the CC with higher WMI.
- PLIC showed increased MD with higher WMI, though the association was less pronounced than in the CC.
- The left PLIC exhibited higher anisotropy and bundle length than the right.
Conclusions:
- Higher WMI scores in preterm infants are associated with reduced anisotropy and increased diffusivity in the CC, indicating compromised white matter integrity.
- A relationship between PLIC microstructural changes and WMI was observed.
- Greater prematurity at birth is associated with more significant effects on brain maturation.
Background And Purpose:
Signal-intensity abnormalities in the PLIC and thinning of the CC are often seen in preterm infants and associated with poor outcome. DTI is able to detect subtle abnormalities. We used FT to select bundles of interest (CC and PLIC) to acquire additional information on the WMI.
Materials And Methods:
One hundred twenty preterm infants born at <31 weeks' gestation with 3T DTI at TEA entered this prospective study. Quantitative information (ie, volume, length, anisotropy, and MD) was obtained from fiber bundles passing through the PLIC and CC. A general linear model was used to assess the effects of factor (sex) and variables (GA, BW, HC, PMA, and WMI) on FT-segmented parameters.
Results:
Seventy-two CC and 85 PLIC fiber bundles were assessed. For the CC, increasing WMI and decreasing FA (P = .038), bundle volume (P < .001), and length (P = .001) were observed, whereas MD increased (P = .001). For PLIC, MD increased with increasing WMI (P = .002). Higher anisotropy and larger bundle length were observed in the left PLIC compared with the right (P = .003, P = .018).
Conclusions:
We have shown that in the CC bundle, anisotropy was decreased and diffusivity was increased in infants with high WMI scores. A relation of PLIC with WMI was also shown but was less pronounced. Brain maturation is affected more if birth was more premature.
