title: Impaired white matter development in extremely low-birth-weight infants with previous brain hemorrhage.
abstract: OBJECTIVE
  Brain hemorrhage is common in premature infants. The purpose of the study is to evaluate white matter development in extremely low-birth-weight infants with or without previous brain hemorrhage.
  
  
  METHODS
  Thirty-three extremely low-birth-weight infants were prospectively enrolled and included in this institutional review board-approved study. Another 10 healthy term infants were included as controls. The medical records of the extremely low-birth-weight infants were reviewed for sonography diagnosis of intraventricular hemorrhage. All infants had an MR imaging examination at term-equivalent age for detection of previous hemorrhage, and their white matter was scored and compared among different groups. DTI measured fractional anisotropy values were also compared voxelwise by tract-based spatial statistics.
  
  
  RESULTS
  Compared with controls, the white matter score was not significantly different in extremely low-birth-weight infants without blood deposition on MR imaging (P = .17), but was significantly worse in extremely low-birth-weight infants with blood deposition on MR imaging but no intraventricular hemorrhage diagnosis by sonography (P = .02), in extremely low-birth-weight infants with grade 1 or 2 intraventricular hemorrhage on sonography (P = .003), and in extremely low-birth-weight infants with grade 3 or 4 intraventricular hemorrhage on sonography (P = .0001). Extremely low-birth-weight infants without blood deposition on MR imaging did not show any white matter regions with significantly lower fractional anisotropy values than controls. Extremely low-birth-weight infants with blood deposition on MR imaging, but no intraventricular hemorrhage diagnosis, did show white matter regions with significantly lower fractional anisotropy values, and extremely low-birth-weight infants with intraventricular hemorrhage diagnosis had widespread white matter regions with lower fractional anisotropy values.
  
  
  CONCLUSIONS
  Previous brain hemorrhage is associated with abnormal white matter in extremely low-birth-weight infants at term-equivalent age, and sonography is not sensitive to minor hemorrhages that are sufficient to cause white matter injury.
authors.affiliation: From the Department of Radiology (X.O., C.M.G., R.H.R., T.L.A.), University of Arkansas for Medical Sciences, Little Rock, Arkansas Pediatric Radiology (X.O., C.M.G., R.H.R.), Arkansas Children's Hospital, Little Rock, Arkansas ouxiawei@uams.edu.
authors.forename: X
authors.initials: X
authors.lastname: Ou
authors.affiliation: From the Department of Radiology (X.O., C.M.G., R.H.R., T.L.A.), University of Arkansas for Medical Sciences, Little Rock, Arkansas Pediatric Radiology (X.O., C.M.G., R.H.R.), Arkansas Children's Hospital, Little Rock, Arkansas.
authors.forename: C M
authors.initials: CM
authors.lastname: Glasier
authors.affiliation: From the Department of Radiology (X.O., C.M.G., R.H.R., T.L.A.), University of Arkansas for Medical Sciences, Little Rock, Arkansas Pediatric Radiology (X.O., C.M.G., R.H.R.), Arkansas Children's Hospital, Little Rock, Arkansas.
authors.forename: R H
authors.initials: RH
authors.lastname: Ramakrishnaiah
authors.affiliation: Departments Pediatrics (S.B.M., A.A.).
authors.forename: S B
authors.initials: SB
authors.lastname: Mulkey
authors.affiliation: Vanderbilt University Institute of Imaging Sciences (Z.D.), Nashville, Tennessee.
authors.forename: Z
authors.initials: Z
authors.lastname: Ding
authors.affiliation: From the Department of Radiology (X.O., C.M.G., R.H.R., T.L.A.), University of Arkansas for Medical Sciences, Little Rock, Arkansas.
authors.forename: T L
authors.initials: TL
authors.lastname: Angtuaco
authors.affiliation: Departments Pediatrics (S.B.M., A.A.) Arkansas Children's Nutrition Center (A.A.), Little Rock, Arkansas.
authors.forename: A
authors.initials: A
authors.lastname: Andres
authors.affiliation: Departments of Pediatrics and Obstetrics and Gynecology, Section of Neonatology (J.R.K.), Baylor College of Medicine, Texas Children's Hospital, Houston, Texas.
authors.forename: J R
authors.initials: JR
authors.lastname: Kaiser
mesh_terms: D016880:Anisotropy; D001921:Brain / Q000254:growth & development*; D002543:Cerebral Hemorrhage / Q000150:complications*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight / Q000254:growth & development*; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000473:pathology*; D008297:Male; D066127:White Matter / Q000473:pathology*