TY - JOUR
T1 - Diffuse excessive high signal intensity in low-risk preterm infants at term-equivalent age does not predict outcome at 1 year
T2 - A prospective study
AU - Leitner, Yael
AU - Weinstein, Maya
AU - Myers, Vicki
AU - Uliel, Shimrit
AU - Geva, Karen
AU - Berger, Irit
AU - Marom, Ronella
AU - Bashat, Dafna Ben
AU - Ben-Sira, Liat
AU - Geva, Ronny
AU - Gross-Tsur, Varda
PY - 2014/8
Y1 - 2014/8
N2 - Introduction: The outcome of premature infants with only diffuse excessive high signal intensity (DEHSI) is not clear. We explored the relationship between DEHSI, white matter (WM) diffusion characteristics, perinatal characteristics, and neurobehavioral outcome at 1 year in a homogenous group of preterm infants without major brain abnormalities. Methods: Fifty-eight preterm infants, gestational age 29±2.6 weeks, underwent an MRI at term-equivalent age (TEA). Griffiths Mental Developmental Scales, neurological assessment, and Parental Stress Index (PSI) were performed at 1 year corrected age. These measures were compared between preterm infants according to DEHSI classification (none, mild, moderate). Diffusion tensor imaging was used in major WM volumes of interest to objectively measure the degree of WM maturation. Results: No significant differences were detected in the perinatal risk characteristics, neurobehavioral outcome, and PSI at 1 year between infants with different DEHSI classifications. In infants with DEHSI, increased axial and radial diffusivities were detected in the optic radiations, centrum semiovale, and posterior limb of the internal capsule, indicating less advanced maturation of the WM. Significant correlations were detected between the time interval from birth to MRI and the WM microstructure in infants without DEHSI. Conclusion: DEHSI in premature infants is neither a predictive measure for short-term adverse neurobehavioral outcome nor related to perinatal risk characteristics. Extrauterine exposure time had a differential effect on WM maturational trajectories in infants with DEHSI compared to those without. We suggest DEHSI may represent an alteration in WM maturational characteristics. Further follow-up studies may verify later consequences of DEHSI in premature infants.
AB - Introduction: The outcome of premature infants with only diffuse excessive high signal intensity (DEHSI) is not clear. We explored the relationship between DEHSI, white matter (WM) diffusion characteristics, perinatal characteristics, and neurobehavioral outcome at 1 year in a homogenous group of preterm infants without major brain abnormalities. Methods: Fifty-eight preterm infants, gestational age 29±2.6 weeks, underwent an MRI at term-equivalent age (TEA). Griffiths Mental Developmental Scales, neurological assessment, and Parental Stress Index (PSI) were performed at 1 year corrected age. These measures were compared between preterm infants according to DEHSI classification (none, mild, moderate). Diffusion tensor imaging was used in major WM volumes of interest to objectively measure the degree of WM maturation. Results: No significant differences were detected in the perinatal risk characteristics, neurobehavioral outcome, and PSI at 1 year between infants with different DEHSI classifications. In infants with DEHSI, increased axial and radial diffusivities were detected in the optic radiations, centrum semiovale, and posterior limb of the internal capsule, indicating less advanced maturation of the WM. Significant correlations were detected between the time interval from birth to MRI and the WM microstructure in infants without DEHSI. Conclusion: DEHSI in premature infants is neither a predictive measure for short-term adverse neurobehavioral outcome nor related to perinatal risk characteristics. Extrauterine exposure time had a differential effect on WM maturational trajectories in infants with DEHSI compared to those without. We suggest DEHSI may represent an alteration in WM maturational characteristics. Further follow-up studies may verify later consequences of DEHSI in premature infants.
KW - DEHSI
KW - DTI
KW - Developmental outcome
KW - MRI
KW - Prematurity
UR - http://www.scopus.com/inward/record.url?scp=84905920221&partnerID=8YFLogxK
U2 - 10.1007/s00234-014-1373-8
DO - 10.1007/s00234-014-1373-8
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AN - SCOPUS:84905920221
SN - 0028-3940
VL - 56
SP - 669
EP - 678
JO - Neuroradiology
JF - Neuroradiology
IS - 8
ER -