Abstract
Background: Prematurity is a well-known risk factor of brain damage. Diffuse white matter injury appears to be more prevalent compared to focal cystic lesions among very preterm infants. Apparent diffusion coefficient (ADC) on diffusion weighted imaging (DWI) is a quantitative measure of molecular diffusion of water. Decrease in ADC relates to maturation and integrity of developing brain.
Objective: To investigate whether ADC values correlate with neurosensory measurements and with neurodevelopmental outcome in very preterm infants.
Design/Methods: A prospective follow-up study comprised 30 infants born before 32 weeks of gestation with birth weight under 1000 g. Conventional magnetic resonance imaging (MRI), DWI, and measurements of brainstem auditory evoked potentials (BAEPs) were performed at term. ADC was measured in six white matter regions. Neurodevelopmental outcome was assessed at two years of corrected age. The study was approved by the ethics committee of Oulu University Hospital.
Results: ADC in pons correlated with latency of wave III in BAEP measurements (r = 0.62, P = 0.018). 33.8% of the variability in latency of wave III was explained by ADC in pons (P = 0.017). A negative correlation was found between scores on gross motor subscale and ADC in corona radiata (r = -0.401, P = 0.038). Furthermore, after dividing the children into three groups according to the scores on gross motor and eye-hand coordination subscales, children with the lowest scores (< - 1SD) had the highest ADC in corona radiata (P<0.05). ADC below 1.28 had sensitivity of 75% and specificity of 96% in finding differences between the groups on gross motor subscale (P = 0.005) and sensitivity of 43% and specificity of 100% in finding differences on eye-hand coordination subscale (P = 0.013).
Conclusions: ADC in a specific brain region on DWI predicts abnormalities in later neurodevelopmental outcome and identifies infants who would benefit from neurologic follow-up.
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Kaukola, T., Perhomaa, M., Vainionpää, L. et al. 194 Diffusion Weighted Imaging: Correlation Between Apparent Diffusion Coefficient, Brainstem Auditory Evoked Potentials, and Neurodevelopmental Outcome. Pediatr Res 58, 387 (2005). https://doi.org/10.1203/00006450-200508000-00223
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DOI: https://doi.org/10.1203/00006450-200508000-00223