Characterization of Extensive Microstructural Variations Associated with Punctate White Matter Lesions in Preterm Neonates
Characterization of Extensive Microstructural Variations Associated with Punctate White Matter Lesions in Preterm Neonates
复制标题
早产新生儿点状白质病变相关的广泛微观结构变异的特征
DOI：
10.3174/ajnr.a5226
复制
发表时间：
2017-06-01
影响因子：
3.5
通讯作者：
Yang, J.
中科院分区：
文献类型：
--
作者：
Li, X.;Gao, J.;Yang, J.
背景和目的：点状脑白质病变在早产儿中很常见。新生儿的神经发育结果与延伸程度有关。本研究旨在表征不同点状白质病变级别的微观结构变化程度。材料与方法：将脑白质点状病变的早产儿分为3级（从轻度到重度：I-III级）。将点状白质病变患者与对照组之间 DTI 衍生的分数各向异性、轴向扩散率和径向扩散率与基于束的空间统计和束量化方法进行比较。结果：纳入了 33 名患有点状白质病变的早产新生儿和 33 名匹配的对照。 Ⅰ级、Ⅱ级、Ⅲ级患者分别为15例、9例、9例。点状白质病变主要位于侧脑室附近的白质，特别是三角区、后角、半卵圆中心和/或放射冠的外侧区域。在具有 III 级点状白质病变的新生儿中观察到广泛的微观结构变化，而 I 级和 II 级的 DTI 指标没有发现显着变化。在 T1WI 和 T2WI 上看到的点状白质病变部位附近的区域中发现了轴向扩散率增加、径向扩散率增加和分数各向异性减少/不变的模式。在远离点状白质病变部位的区域观察到轴向扩散率不变、径向扩散率增加以及分数各向异性减少/不变。结论：不同等级的点状白质病变的白质微观结构变化是不同的。在患有严重点状白质病变的新生儿中，广泛的变化模式根据距病变部位的距离而变化。这些发现可能有助于确定点状白质病变的结果并选择治疗策略。
BACKGROUND AND PURPOSE: Punctate white matter lesions are common in preterm neonates. Neurodevelopmental outcomes of the neonates are related to the degree of extension. This study aimed to characterize the extent of microstructural variations for different punctate white matter lesion grades. MATERIALS AND METHODS: Preterm neonates with punctate white matter lesions were divided into 3 grades (from mild to severe: grades I–III). DTI-derived fractional anisotropy, axial diffusivity, and radial diffusivity between patients with punctate white matter lesions and controls were compared with Tract-Based Spatial Statistics and tract-quantification methods. RESULTS: Thirty-three preterm neonates with punctate white matter lesions and 33 matched controls were enrolled. There were 15, 9, and 9 patients, respectively, in grades I, II, and III. Punctate white matter lesions were mainly located in white matter adjacent to the lateral ventricles, especially regions lateral to the trigone, posterior horns, and centrum semiovale and/or corona radiata. Extensive microstructural changes were observed in neonates with grade III punctate white matter lesions, while no significant changes in DTI metrics were found for grades I and II. A pattern of increased axial diffusivity, increased radial diffusivity, and reduced/unchanged fractional anisotropy was found in regions adjacent to punctate white matter lesion sites seen on T1WI and T2WI. Unchanged axial diffusivity, increased radial diffusivity, and reduced/unchanged fractional anisotropy were observed in regions distant from punctate white matter lesion sites. CONCLUSIONS: White matter microstructural variations were different across punctate white matter lesion grades. Extensive change patterns varied according to the distance to the lesion sites in neonates with severe punctate white matter lesions. These findings may help in determining the outcomes of punctate white matter lesions and selecting treatment strategies.