Ying Qi, Presenter: Nothing to Disclose

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

Qiyong Guo MD, Abstract Co-Author: Nothing to Disclose

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

100 preterm infants with PWML were identified on MRI and DWI. DTI and MRS were performed when they were stable. The grades of PWML were described from Ⅰ to Ⅲ on conventional MRI and DWI. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were obtained for 20 cerebral regions of interest (ROI).NAA/Cr, Cho/Cr, Glx/Cr, Lac/Cr and mI/Cr were calculated beside the lateral cerebral ventricle。Follow-up MRI and neurodevelopmental assessment were performed.

There were 34, 41 and 25 infants in GradeⅠ, Ⅱ and Ⅲ. Compared with the infants in Grade Ⅰ, infants in Grade Ⅱ and Ⅲ had significantly lower FA values in centrum semiovale, lateral cerebral ventricle and posterior limb of internal capsule (P<.05). Infants in Grade Ⅱ and Ⅲ had significantly higher ADC values in lateral cerebral ventricle and posterior limb of internal capsule (P<.05). There was no significant difference of the FA and ADC values between the infants in Grade Ⅱ and Ⅲ in other ROIs (P>.05). There were significantly difference of Cho/Cr, Glx/Cr, Lac/Cr and mI/Cr among the infants in Grade Ⅰ, Ⅱ and Ⅲ(P<.05). Corresponding to the classification, there were 27, 28 and 23 infants followed up respectively. The morbidities of PVL, ventricular dilation, atrophy of the white matter and/or neurodevelopmental delay were 7.41% (2/27), 67.86% (19/28) and 95.65% (22/23) accordingly. 

PWML in Grade Ⅱ and Ⅲ might interfere the myelinization in cerebral microstructure of preterm infants. The higher Grade of PWML, the higher possibility of cerebral metabolic changes and their prognostic abnormality is.

The preterm 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, Guo, Q, Punctate White Matter Lesions in Preterm Infants Using DTI, MRS, and MRI.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14005979.html