title: Effects of Posthemorrhagic Ventricular Dilatation in the Preterm Infant on Brain Volumes and White Matter Diffusion Variables at Term-Equivalent Age.
abstract: OBJECTIVE
  To evaluate the differential impact of germinal matrix-intraventricular hemorrhage (GMH-IVH) and posthemorrhagic ventricular dilatation (PHVD) on brain and cerebrospinal fluid (CSF) volumes and diffusion variables in preterm born infants at term-equivalent age (TEA).
  
  
  METHODS
  Nineteen infants (gestational age <31 weeks) with GMH-IVH grade II-III according to Papile et al and subsequent PHVD requiring intervention were matched against 19 controls with GMH-IVH grade II but no PHVD and 19 controls without GMH-IVH. Outcome variables on magnetic resonance imaging (MRI) including diffusion weighted imaging at TEA were volumes of white matter, cortical gray matter, deep gray matter, brainstem, cerebellum, ventricles, extracerebral CSF, total brain tissue, and intracranial volume (ICV), as well as white matter and cerebellar apparent diffusion coefficients (ADCs). Effects of GMH-IVH and PHVD on TEA-MRI measurements were evaluated using multivariable regression analysis. Brain and CSF volumes were adjusted for ICV to account for differences in bodyweight at TEA-MRI and ICV between cases and controls.
  
  
  RESULTS
  PHVD was independently associated with volumes of deep gray matter (β [95% CI]: -1.4 cc [-2.3; -.5]), cerebellum (-2.7 cc [-3.8; -1.6]), ventricles (+12.7 cc [7.9; 17.4]), and extracerebral CSF (-11.2 cc [-19.2; -3.3]), and with ADC values in occipital, parieto-occipital, and parietal white matter (β: +.066-.119×10(-3) mm(2)/s) on TEA-MRI (P < .05). No associations were found between GMH-IVH grade II-III and brain and CSF volumes or ADC values at TEA.
  
  
  CONCLUSIONS
  PHVD was negatively related to deep gray matter and cerebellar volumes and positively to white matter ADC values on TEA-MRI, despite early intervention for PHVD in the majority of the infants. These relationships were not observed for GMH-IVH.
authors.affiliation: Department of Neonatology, Wilhelmina Children's Hospital, Utrecht, The Netherlands; Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Margaretha J
authors.initials: MJ
authors.lastname: Brouwer
authors.affiliation: Department of Neonatology, Wilhelmina Children's Hospital, Utrecht, The Netherlands; Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Linda S
authors.initials: LS
authors.lastname: de Vries
authors.affiliation: Department of Neonatology, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
authors.forename: Karina J
authors.initials: KJ
authors.lastname: Kersbergen
authors.affiliation: Department of Neonatology, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
authors.forename: Nicolaas E
authors.initials: NE
authors.lastname: van der Aa
authors.affiliation: Department of Neonatology, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
authors.forename: Annemieke J
authors.initials: AJ
authors.lastname: Brouwer
authors.affiliation: Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Max A
authors.initials: MA
authors.lastname: Viergever
authors.affiliation: Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Ivana
authors.initials: I
authors.lastname: Išgum
authors.affiliation: Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Kuo S
authors.initials: KS
authors.lastname: Han
authors.affiliation: Department of Neonatology, Wilhelmina Children's Hospital, Utrecht, The Netherlands; Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Floris
authors.initials: F
authors.lastname: Groenendaal
authors.affiliation: Department of Neonatology, Wilhelmina Children's Hospital, Utrecht, The Netherlands; Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: m.benders@umcutrecht.nl.
authors.forename: Manon J N L
authors.initials: MJNL
authors.lastname: Benders
mesh_terms: D001921:Brain / Q000473:pathology*; D002543:Cerebral Hemorrhage / Q000150:complications*; D002552:Cerebral Ventricles / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D004108:Dilatation, Pathologic; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases; D007363:Intensive Care Units, Neonatal; D008297:Male; D009426:Netherlands; D047929:Term Birth; D066127:White Matter / Q000473:pathology*