Ying Qi, Presenter: Nothing to Disclose

Xiaoming Wang MD, Abstract Co-Author: Nothing to Disclose

This study aimed to detect the impacts on cerebral microstructure, neurodevelopment and their pathological changes of punctate white matter lesions (PWML) by using SWI, DTI and conventional MRI.

87 preterm infants with PWML and 35 preterm infants in controls were identified on MRI and DWI. SWI or DTI was randomly performed after serial MRI scans. They were classified as SWI group, DTI group and follow-up MRI group. In SWI group, to observe whether the lesions showed signal-intensity loss. In DTI group, fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were obtained for 20 cerebral regions of interest (ROI). In the follow-up MRI group, the grades of PWML were described on conventional MRI and DWI. Follow-up MRI and neurodevelopmental assessment were performed.

There were 35 infants (22 with PWML, 13 in controls) in SWI group, 37 infants (25 with PWML, 12 in controls) in DTI group and 122 infants (87 with PWML, 35 in controls) in follow-up MRI group. In SWI group, we found that 19 infants (19/22) with PWML showed the lesions hyperintensity and 3 infants (3/22) with PWML showed signal-intensity loss. Infants in controls showed no abnormalities. In DTI group, compared with the infants in controls, infants with PWML had significantly lower FA values only in bilateral centrum semiovale and parietal watershed white matter (P<.05). There was no significant difference between the ADC values in infants with PWML and infants in controls in all the ROIs (P>.05). In follow-up group，there were 27, 37 and 23 infants with PWML in GradeⅠ, Ⅱ and Ⅲ. Corresponding to the classification, there were 14, 21 and 22 infants followed up respectively. The morbidities of PVL, ventricular dilation and/or atrophy of the white matter and/or neurodevelopmental delay were 3.70% (1/27), 48.65% (18/37) and 95.65% (22/23) accordingly. 23 infants (23/35) in controls were followed up. Their brain MRI and neurodevelopmental outcomes were normal.

PWML are non-hemorrhagic lesions. PWML might interfere the myelinization in cerebral microstructure. The higher Grade of PWML, the higher possibility of prognostic abnormality.

The infants with PWML in GradeⅠoften have normal outcomes of MRI and neurodevelopment. The infants with PWML in Grade Ⅱ or Ⅲ often have cerebral palsy or neurodevelopmental delay.

Qi, Y, Wang, X, Punctate White Matter Lesions: SWI, DTI, and MRI in Preterm Infants.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11014037.html