title: Neonatal DTI early after birth predicts motor outcome in preterm infants with periventricular hemorrhagic infarction.
abstract: BACKGROUND
  To determine the association between early neonatal diffusion tensor imaging (DTI) and the development of unilateral spastic cerebral palsy (USCP) in preterm infants with periventricular hemorrhagic infarction (PVHI).
  
  
  METHODS
  Preterm infants with PVHI were assessed with early (≤4 wk after birth) and term-equivalent age MRI-DTI. Involvement of corticospinal tracts was assessed by visual assessment of the posterior limb of the internal capsule (PLIC) on DTI (classified asymmetrical, equivocal, or symmetrical) and by an atlas-based approach calculating fractional anisotropy asymmetry index in the PLIC. Motor outcome was assessed at ≥15 mo corrected age.
  
  
  RESULTS
  Seven out of 23 infants with PVHI developed USCP. Their PLIC was visually scored as asymmetrical in 6 and equivocal in 1 on the early DTI. Thirteen out of 16 infants with a symmetrical motor development had a symmetrical PLIC on early DTI, the remaining 3 were equivocal. All infants with USCP had a fractional anisotropy asymmetry index of >0.05 (optimal cut-off value) on early DTI. In infants with a symmetrical motor development (n = 16), 14 had an asymmetry index ≤0.05 while 2 had an index >0.05.
  
  
  CONCLUSIONS
  DTI in preterm infants with PVHI within a few weeks after birth is associated with later motor development.
authors.affiliation: Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands.
authors.forename: Elise
authors.initials: E
authors.lastname: Roze
authors.affiliation: Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands.
authors.forename: Manon J
authors.identifier: 0000000154919168
authors.initials: MJ
authors.lastname: Benders
authors.affiliation: Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands.
authors.forename: Karina J
authors.initials: KJ
authors.lastname: Kersbergen
authors.affiliation: Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands.
authors.forename: Niek E
authors.initials: NE
authors.lastname: van der Aa
authors.affiliation: Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands.
authors.forename: Floris
authors.initials: F
authors.lastname: Groenendaal
authors.affiliation: Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands.
authors.forename: Ingrid C
authors.initials: IC
authors.lastname: van Haastert
authors.affiliation: Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Alexander
authors.initials: A
authors.lastname: Leemans
authors.affiliation: Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands.
authors.forename: Linda S
authors.initials: LS
authors.lastname: de Vries
mesh_terms: D016880:Anisotropy; D020520:Brain Infarction / Q000473:pathology*; D002547:Cerebral Palsy / Q000175:diagnosis / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D003071:Cognition; D056324:Diffusion Tensor Imaging; D005260:Female; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000473:pathology*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D015931:Intensive Care, Neonatal; D008279:Magnetic Resonance Imaging; D008297:Male; D009048:Motor Skills; D009483:Neuropsychological Tests; D012372:ROC Curve; D016896:Treatment Outcome