Related Experiment Video
Updated: Apr 25, 2026
Advanced Diffusion Imaging in The Hippocampus of Rats with Mild Traumatic Brain Injury
Published on: August 14, 2019
White matter injury in newborns with congenital heart disease: a diffusion tensor imaging study
Sarah B Mulkey1, Xiawei Ou2, Raghu H Ramakrishnaiah2
1Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Insights
Tract-based spatial statistics (TBSS) effectively detects white matter injury in newborns with congenital heart disease. This diffusion tensor imaging technique shows greater sensitivity than conventional MRI for identifying subtle brain abnormalities.
Area of Science:
- Neuroimaging
- Pediatric Neurology
- Cardiology
Background:
- Congenital heart disease (CHD) in newborns is frequently associated with preoperative brain injury, detectable via cranial magnetic resonance imaging (MRI).
- Diffusion tensor imaging (DTI) offers sensitive assessment of white matter integrity, crucial for understanding neurological outcomes.
Purpose of the Study:
- To evaluate the efficacy of tract-based spatial statistics (TBSS) for analyzing DTI data in newborns with CHD.
- To compare the sensitivity of TBSS in detecting white matter injury versus conventional MRI.
Main Methods:
- Prospective enrollment of 19 term newborns with CHD requiring early surgery.
- Preoperative and postoperative brain MRI with DTI, analyzed using TBSS to assess white matter fractional anisotropy (FA).
- Comparison between CHD infants with and without preoperative brain injury, and between CHD infants and term control infants.
Main Results:
- Conventional MRI identified preoperative brain injury in 10 infants.
- TBSS revealed significantly lower FA in major white matter tracts for infants with preoperative brain injury (P < 0.05, corrected).
- FA values increased from pre- to postoperative scans, correlating with brain maturation; control infants showed higher FA than CHD infants.
Conclusions:
- Tract-based spatial statistics is a valuable DTI analysis technique for detecting white matter injury in newborns with CHD.
- TBSS demonstrates superior sensitivity compared to conventional MRI in identifying subtle white matter abnormalities in this population.
Background:
Brain injury is observed on cranial magnetic resonance imaging preoperatively in up to 50% of newborns with congenital heart disease. Newer imaging techniques such as diffusion tensor imaging provide sensitive measures of the white matter integrity. The objective of this study was to evaluate the diffusion tensor imaging analysis technique of tract-based spatial statistics in newborns with congenital heart disease.
Methods:
Term newborns with congenital heart disease who would require surgery at less than 1 month of age were prospectively enrolled (n = 19). Infants underwent preoperative and postoperative brain magnetic resonance imaging with diffusion tensor imaging. Tract-based spatial statistics, an objective whole-brain diffusion tensor imaging analysis technique, was used to determine differences in white matter fractional anisotropy between infant groups. Term control infants were also compared with congenital heart disease infants. Postmenstrual age was equivalent between congenital heart disease infant groups and between congenital heart disease and control infants.
Results:
Ten infants had preoperative brain injury, either infarct or white matter injury, by conventional brain magnetic resonance imaging. The technique of tract-based spatial statistics showed significantly lower fractional anisotropy (P < 0.05, corrected) in multiple major white matter tracts in the infants with preoperative brain injury compared with infants without preoperative brain injury. Fractional anisotropy values increased in the white matter tracts from the preoperative to the postoperative brain magnetic resonance imaging correlating with brain maturation. Control infants had higher fractional anisotropy in multiple white matter tracts compared with infants with congenital heart disease.
Conclusion:
Tract-based spatial statistics is a valuable diffusion tensor imaging analysis technique that may have better sensitivity in detecting white matter injury compared with conventional brain magnetic resonance imaging in term newborns with congenital heart disease.
