Automatically quantified diffuse excessive high signal intensity on MRI predicts cognitive development in preterm infants.
Automatically quantified diffuse excessive high signal intensity on MRI predicts cognitive development in preterm infants.
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DOI：
10.1016/j.pediatrneurol.2013.08.026
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发表时间：
2013-12
影响因子：
3.8
通讯作者：
Kaur S
中科院分区：
文献类型：
--
作者：
Parikh NA;He L;Bonfante-Mejia E;Hochhauser L;Wilder PE;Burson K;Kaur S
认知和语言障碍构成早产儿中观察到的大多数残疾。目前尚不清楚足月时MRI上弥漫性过高信号强度（DEHSI）是否代表白色物质成熟延迟或病理学。我们假设，在41名极低出生体重（ELBW; ≤ 1000 g）婴儿的队列中，足月时基于弥散张量成像的客观定量DEHSI测量将是2年时认知和语言发育的强预测因子。使用自动概率图谱，平均扩散率图用于客观分割和量化DEHSI体积和平均、轴向和径向扩散率测量。标准化的神经发育在2岁时使用贝利婴儿发育量表（第三版）进行评估。41名婴儿中有36名（88%）在随访时有完整的发育数据。客观量化的DEHSI体积与2年时的认知和语言评分显著相关（P<0.001）。检测到的DEHSI区域中的三个扩散率测量值的总和也与Bayley评分显著相关（R2 34.7%; P<0.001）。DEHSI体积最高四分位数的婴儿得分比最低四分位数的婴儿低19-24分（P<0.01）。然而，当神经放射科医生进行主观诊断时，广泛DEHSI婴儿的Bayley评分并没有显著降低。这些发现进一步证明DEHSI是病理性的，并且客观量化的基于弥散的DEHSI体积与认知和语言障碍相关。我们的方法可用于危险分层和早期干预，这样的高危极早产儿。
Cognitive and language impairments constitute the majority of disabilities observed in preterm infants. It remains unclear if diffuse excessive high signal intensity (DEHSI) on MRI at term represents delayed white matter maturation or pathology. We hypothesized that diffusion tensor imaging-based objectively quantified DEHSI measures at term will be strong predictors of cognitive and language development at 2 years in a cohort of 41 extremely low birth weight (ELBW; ≤1000g) infants. Using an automated probabilistic atlas, mean diffusivity maps were used to objectively segment and quantify DEHSI volume and mean, axial, and radial diffusivity measures. Standardized neurodevelopment was assessed at 2 years of age using the Bayley Scales of Infant Development, third edition. Thirty-six of the 41 infants (88%) had complete developmental data at follow-up. Objectively quantified DEHSI volume correlated significantly with cognitive and language scores at 2 years (P<0.001 for both). The sum values of the three diffusivity measures in detected DEHSI regions also correlated significantly with the Bayley scores (R2 34.7%; P<0.001 for each). Infants in the highest quartile for DEHSI volumes had scores between 19–24 points lower than infants in the lowest quartile (P<0.01). When diagnosed subjectively by neuroradiologists however, Bayley scores were not significantly lower in infants with extensive DEHSI. These findings lend further evidence that DEHSI is pathologic and that objectively quantified diffusion-based DEHSI volume at term is associated with cognitive and language impairments. Our approach could be utilized for risk stratification and early intervention for such high-risk extremely preterm infants.
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DOI：
10.1016/j.bbi.2012.12.012
发表时间：
2013-03
期刊：
Brain, behavior, and immunity
影响因子：
--
作者：
O'Shea TM;Shah B;Allred EN;Fichorova RN;Kuban KCK;Dammann O;Leviton A;ELGAN Study Investigators
通讯作者：
ELGAN Study Investigators
影响因子：
5.7
作者：
He L;Parikh NA
通讯作者：
Parikh NA
影响因子：
8
作者：
Hintz, SR;Kendrick, DE;Higgins, RD
通讯作者：
Higgins, RD
影响因子：
4.8
作者：
Smith, SM
通讯作者：
Smith, SM
影响因子：
8
作者：
Nordhov, S. Marianne;Ronning, John A.;Kaaresen, Per Ivar
通讯作者：
Kaaresen, Per Ivar