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[An assessment of white matter development in preterm infants with bronchopulmonary dysplasia using diffusion tensor
Yin-Juan Wang1, Sha-Sha Liu, Yan-Chao Liu
1Department of Neonatology, Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China. xufalin72@126.com.
Insights
Bronchopulmonary dysplasia (BPD) in preterm infants is linked to delayed white matter development, indicated by altered diffusion tensor imaging (DTI) metrics. This highlights the need for monitoring neurological function in affected infants.
Area of Science:
- Neonatal neurology
- Pediatric radiology
- Neurodevelopmental disorders
Background:
- Bronchopulmonary dysplasia (BPD) is a common complication in preterm infants.
- Preterm birth can lead to abnormal brain development.
- Diffusion Tensor Imaging (DTI) is a valuable tool for assessing white matter integrity.
Purpose of the Study:
- To evaluate white matter development in preterm infants with BPD.
- To compare DTI-derived fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values between infants with and without BPD.
- To investigate the association between BPD and white matter microstructure.
Main Methods:
- Ninety-six preterm infants (gestational age ≤32 weeks) underwent head MRI with DTI.
- Infants were categorized into BPD (n=48) and non-BPD (n=48) groups based on discharge diagnosis.
- FA and ADC values were analyzed in specific white matter regions.
Main Results:
- Infants with BPD showed significantly lower FA and higher ADC values in key white matter tracts (internal capsule, corpus callosum, cerebellum, etc.) compared to controls.
- No significant differences in hemorrhage or leukomalacia rates were observed between groups.
- BPD infants had higher rates of apnea, pneumonia, and longer mechanical ventilation duration.
Conclusions:
- BPD is associated with impaired white matter development in preterm infants.
- Altered DTI metrics suggest delayed myelination or axonal damage in BPD.
- Close monitoring of neurological outcomes is crucial for preterm infants with BPD.
Objective:
To assess white matter development in preterm infants with bronchopulmonary dysplasia (BPD) using fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of diffusion tensor imaging (DTI).
Methods:
Ninety-six infants with a gestational age of ≤32 weeks and a birth weight of <1 500 g who were admitted to the neonatal intensive care unit within 24 hours after birth from August 2016 to April 2019 and underwent head MRI and DTI before discharge were enrolled. According to the discharge diagnosis, they were divided into BPD group with 48 infants and non-BPD group with 48 infants. The two groups were compared in terms of FA and ADC values of the same regions of interest on DTI image.
Results:
There were no significant differences in the incidence rates of periventricular/intraventricular hemorrhage, periventricular leukomalacia, and punctate white matter lesions between the two groups (P>0.05). Compared with the non-BPD group, the BPD group had significantly lower FA values and significantly higher ADC values of the posterior limb of the internal capsule, the splenium of the corpus callosum, the occipital white matter, the cerebellum, and the cerebral peduncle (P<0.05). Compared with the non-BPD group, the BPD group had a significantly higher frequency of apnea, a significantly higher proportion of infants with pneumonia or mechanical ventilation, and a significantly longer duration of assisted ventilation (P<0.05).
Conclusions:
BPD may has potential adverse effects to white matter development in preterm infants, leading to delayed white matter development. Therefore, it is necessary to pay attention to the neurological function of these infants.
