Diffusion-weighted imaging of cerebral white matter and the cerebellum following preterm birth.
OBJECTIVE
The aim of this study was to determine if apparent diffusion coefficients (ADCs) generated with diffusion-weighted imaging of cerebral white matter and the cerebellum are affected by white matter damage.


METHODS
Seventy-two preterm infants (32 males, 40 females; mean gestational age at birth 30.3 wks, SD 3.0 wks; mean birthweight 1458g, SD 534g) underwent magnetic resonance imaging of the brain around term-equivalent age and were categorized into three groups: normal, overt abnormality, and diffuse excessive high signal intensity (DEHSI). ADC values were calculated from cerebral white matter, cerebellar hemispheres, and cerebellar midline, and were compared between groups. Regression analysis identified clinical parameters correlated with ADC values.


RESULTS
Imaging was normal in 27 infants, and revealed overt abnormalities in 14 and DEHSI in 31. ADC values did not differ between groups. ADC values from cerebral white matter were negatively correlated with the number of episodes of postnatal sepsis (p=0.002). ADC values from cerebellar hemispheres (p=0.007) and cerebellar midline (p=0.036) correlated with gestational age at birth.


CONCLUSIONS
ADC values from white matter are not altered in preterm infants with DEHSI but are negatively correlated with the number of episodes of postnatal sepsis. ADC values in the cerebellum are not altered by white matter damage, but are affected by preterm birth itself.
Department of Neonatology, Sheffield Teaching Hospital NHS Foundation Trust, Tree Root Walk, Sheffield, UK. t.hart@doctors.org.uk
Anthony R
AR
Hart
Elspeth H
EH
Whitby
Simon J
SJ
Clark
Martyn N J
MN
Paley
Michael F
MF
Smith
D001921:Brain / Q000002:abnormalities / Q000473:pathology*; D002531:Cerebellum / Q000002:abnormalities / Q000473:pathology; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D047928:Premature Birth; D012044:Regression Analysis; D018805:Sepsis / Q000473:pathology*