Diffusion tensor imaging assesses white matter injury in neonates with hypoxic-ischemic encephalopathy
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Published on: August 14, 2019
Hong-Xin Li1,2, Xing Feng1, Qian Wang3
1Department of Neonatology, Children's Hospital of Soochow University, Suzhou, Jiangsu Province, China.
Insights
Diffusion tensor imaging (DTI) can now quantify white matter damage in neonates with hypoxic-ischemic encephalopathy. This advanced imaging technique offers a clearer prognosis for infants surviving brain injury.
Area of Science:
- Neonatal neurology
- Neuroimaging
- Pediatric neurology
Background:
- Neonatal survival rates have improved, increasing the need for early prognosis in hypoxic-ischemic encephalopathy (HIE).
- Conventional imaging methods like MRI, CT, and ultrasound are insufficient for quantifying white matter damage in neonates.
Purpose of the Study:
- To evaluate the feasibility of diffusion tensor imaging (DTI) in assessing white matter damage in term neonates with HIE.
- To determine if DTI metrics can correlate with neurological assessment scores in this population.
Main Methods:
- Diffusion tensor imaging (DTI) was performed on 10 healthy term infants and 22 term neonates with HIE (14 moderate, 8 severe).
- Key DTI metrics analyzed included fractional anisotropy (FA) and fiber bundle characteristics.
- Correlation analysis was performed between DTI metrics and neonatal behavioral neurological assessment scores.
Main Results:
- Significant differences in FA, voxel volume, and fiber bundle counts were observed in specific brain areas between HIE infants and controls.
- The strongest correlation between FA values and neurological assessment scores was found in the posterior limbs of the internal capsule.
- DTI effectively identified and quantified white matter abnormalities in neonates with HIE.
Conclusions:
- Diffusion tensor imaging (DTI) is a feasible and effective method for quantifying white matter injury in neonates diagnosed with hypoxic-ischemic encephalopathy (HIE).
- DTI findings correlate with clinical assessments, aiding in the prognosis of HIE.
- This technique advances the neuroimaging assessment of brain injury in high-risk newborns.
Abstract:
With improvements in care of at-risk neonates, more and more children survive. This makes it increasingly important to assess, soon after birth, the prognosis of children with hypoxic-ischemic encephalopathy. Computed tomography, ultrasound, and conventional magnetic resonance imaging are helpful to diagnose brain injury, but cannot quantify white matter damage. In this study, ten full-term infants without brain injury and twenty-two full-term neonates with hypoxic-ischemic encephalopathy (14 moderate cases and 8 severe cases) underwent diffusion tensor imaging to assess its feasibility in evaluating white matter damage in this condition. Results demonstrated that fractional anisotropy, voxel volume, and number of fiber bundles were different in some brain areas between infants with brain injury and those without brain injury. The correlation between fractional anisotropy values and neonatal behavioral neurological assessment scores was closest in the posterior limbs of the internal capsule. We conclude that diffusion tensor imaging can quantify white matter injury in neonates with hypoxic-ischemic encephalopathy.
