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Updated: Sep 13, 2025
Early Pathological and Magnetic Resonance Detection of Cerebral Injury Using a Rat Model of Neonatal Hypoxic Ischemic Encephalopathy
Published on: October 28, 2022
Multimodal MRI Techniques Reveal Brain Iron Deposition and Glymphatic Dysfunction in newborns with Hypoxic-Ischemic
Shilong Tang1, Ting Wei2, Pengyu Xiao2
1Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing 400014, China (S.T.); Department of Anatomy, Basic Medical College, Chongqing Medical University, Chongqing 400010, China (S.T., T.W., P.X., Q.Y., Y.L., W.L., J.H.); Institute of Neuroscience, Basic Medical College, Chongqing Medical University, Chongqing, China (S.T., T.W., P.X., Q.Y., Y.L., W.L., J.H.); Key Laboratory of Major Brain Disease and Aging Research (Ministry of Education), Chongqing Medical University, Chongqing, China (S.T., T.W., P.X., Q.Y., Y.L., W.L., J.H.).
Insights
Newborns with hypoxic-ischemic encephalopathy (HIE) show increased brain iron content and impaired glymphatic function. These findings, measured by quantitative susceptibility mapping (QSM) and diffusion tensor imaging (DTI-ALPS), aid in diagnosing HIE.
Area of Science:
- Neuroimaging
- Neonatal Neurology
- Biomarkers
Background:
- Hypoxic-ischemic encephalopathy (HIE) is a major cause of neonatal brain injury.
- Cerebral iron accumulation and impaired glymphatic function are implicated in HIE pathogenesis.
- Non-invasive imaging biomarkers are needed for early HIE detection and management.
Purpose of the Study:
- To investigate cerebral iron content using quantitative susceptibility mapping (QSM).
- To evaluate glymphatic system function via diffusion tensor imaging - apparent lateral projection streamline (DTI-ALPS).
- To identify imaging markers for HIE in newborns.
Main Methods:
- Prospective study of 57 newborns with HIE and 50 healthy controls (1-28 days old).
- All neonates underwent advanced MRI sequences (T1 Flair, T2 Flair, 3D-T1, ESWAN, DTI).
- QSM and DTI-ALPS values were computed to assess iron content and glymphatic function, respectively.
Main Results:
- Elevated QSM values in frontal lobe, temporal lobe, and basal ganglia of HIE newborns (P < 0.05).
- Decreased DTI-ALPS values observed in HIE group (P < 0.05).
- Significant negative correlation between QSM and DTI-ALPS values; combined parameters effectively discriminated HIE from controls (P < 0.05).
Conclusions:
- Newborns with HIE exhibit increased brain iron deposition.
- Glymphatic system function is compromised in HIE neonates.
- QSM and DTI-ALPS are promising imaging biomarkers for HIE detection and understanding its pathophysiology.
Rationale And Objective:
To investigate the cerebral iron content and glymphatic function in newborns with HIE.
Methods:
A total of 57 newborns with HIE, aged 1-28 days, were prospectively selected to constitute the HIE group. Meanwhile, 50 healthy newborns were selected as the control group. All the newborns underwent T1 Flair, T2 Flair, 3D-T1, ESWAN, and DTI sequence scans. Subsequently, software processing was performed to obtain the QSM values reflecting iron contents in brain regions and the DTI-ALPS values evaluating the function of glymphatic system. Comparative analysis of the QSM and DTI-ALPS values between the two groups were carried out to identify the characteristic parameters in the brain regions of newborns with HIE. ROC curve analysis was then utilized to detect the sensitivity of QSM value and DTI-ALPS index.
Results:
In newborns with HIE, the QSM values in the frontal lobe, temporal lobe, and basal ganglia were significantly elevated (P < 0.05). the DTI-ALPS values were notably decreased (P < 0.05). The QSM values in different brain regions such as the frontal lobe, temporal lobe, and basal ganglia were respectively negative correlated with the DTI-ALPS value. The QSM values of the frontal lobe, temporal lobe and basal ganglia, in combination with the DTI-ALPS values, facilitated the discrimination of newborns with HIE from those in the control group (P < 0.05).
Conclusion:
In newborns with HIE, a significant increase in brain iron content was manifested, concomitant with a compromised glymphatic dysfunction. KEY POINTS AND CLINICAL RELEVANCE STATEMENT.
