Correlation Between White Matter Injury Identified by Neonatal Diffusion Tensor Imaging and Neurodevelopmental Outcomes Following Term Neonatal Asphyxia and Therapeutic Hypothermia: An Exploratory Pilot Study
Correlation Between White Matter Injury Identified by Neonatal Diffusion Tensor Imaging and Neurodevelopmental Outcomes Following Term Neonatal Asphyxia and Therapeutic Hypothermia: An Exploratory Pilot Study
复制标题
DOI：
10.1177/0883073819841717
复制
发表时间：
2019-09-01
影响因子：
1.9
通讯作者：
Poretti, Andrea
中科院分区：
文献类型：
--
作者：
Gerner, Gwendolyn J.;Newman, Eric, I;Poretti, Andrea
目的：缺氧缺血性脑病与深部灰质损害有关；然而，白质受累已被公认。这项研究探讨了患者和临床对照组在扩散张量成像方面的差异，以及扩散张量成像与神经发育结果之间的关系。方法：对31例经治疗性亚低温治疗的新生儿缺氧缺血性脑病及10例临床对照进行弥散张量成像。一组缺氧缺血性脑病患者(n=14)的神经发育结果与扩散张量成像标量相关。结果：扩散张量成像标量在壳核、半卵圆中心前后部、胼胝体压部有明显的组间差异。这些感兴趣区的差异与20到32个月大的神经发育结果相关。结论：治疗性低温可能不是对缺氧缺血性脑病的完全干预，因为新生儿脑白质改变可能继续明显，但进一步的研究是有必要的。在这项探索性先导研究中，新生儿弥散张量成像上的脑白质变化模式与神经发育结局相关。
Aim: Hypoxic-ischemic encephalopathy is associated with damage to deep gray matter; however, white matter involvement has become recognized. This study explored differences between patients and clinical controls on diffusion tensor imaging, and relationships between diffusion tensor imaging and neurodevelopmental outcomes. Method: Diffusion tensor imaging was obtained for 31 neonates after hypoxic-ischemic encephalopathy treated with therapeutic hypothermia and 10 clinical controls. A subgroup of patients with hypoxic-ischemic encephalopathy (n = 14) had neurodevelopmental outcomes correlated with diffusion tensor imaging scalars. Results: Group differences in diffusion tensor imaging scalars were observed in the putamen, anterior and posterior centrum semiovale, and the splenium of the corpus callosum. Differences in these regions of interest were correlated with neurodevelopmental outcomes between ages 20 and 32 months. Conclusion: Therapeutic hypothermia may not be a complete intervention for hypoxic-ischemic encephalopathy, as neonatal white matter changes may continue to be evident, but further research is warranted. Patterns of white matter change on neonatal diffusion tensor imaging correlated with neurodevelopmental outcomes in this exploratory pilot study.