AJDRAJNR - American Journal of Neuroradiology

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PEDIATRICS

Early Assessment of Brain Maturation by MR Imaging Segmentation in Neonates and Premature Infants

A. Zachariaa, S. Ziminea, K.O. Lovblada,b, S. Warfieldc, H. Thoenyd, C. Ozdobab, E. Bossie, R. Kreisf, C. Boeschf, G. Schrothb and P.S. Hüppig

a Neuroradiology Unit, Radiology Department, Geneva University, Switzerland
b Institut für Neuroradiologie, DRNN, Inselspital CH-3010 Bern, Switzerland
c Computational Radiology Laboratory, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass
d Department of Radiology, Bern University Hospital, Bern, Switzerland
e Neonatologie, Kinderspital, Inselspital, CH-3010 Bern, Switzerland
f MR Spectroscopy and Methodology Unit, the Department of Clinical Research, University of Bern, Bern, Switzerland
g Child Development Unit, Children’s Hospital, Geneva, Switzerland

Address correspondence to: Karl-Olof Lovblad, MD, Neuroradiology SRRI, Geneva University Hospital, Rue Micheli-du-Crest 24, CH-1211 Geneva 14, Switzerland

PURPOSE: We evaluated the impact of premature extrauterine life on brain maturation.

PATIENTS AND METHODS: Twelve neonates underwent MR imaging at 40 (39.64 ± 0.98) weeks (full term). Fifteen premature infants underwent 2 MR imaging examinations, after birth (preterm at birth) and at 40 weeks (41.03 ± 1.33) (preterm at term). A 3D MR imaging technique was used to measure brain volumes compared with intracranial volume: total brain volume, cortical gray matter, myelinated white matter, unmyelinated white matter, basal ganglia (BG), and CSF.

RESULTS: The average absolute volume of intracranial volume (269.8 mL ± 36.5), total brain volume (246.5 ± 32.3), cortical gray matter (85.53 mL ± 22.23), unmyelinated white matter (142.4 mL ±14.98), and myelinated white matter (6.099 mL ±1.82) for preterm at birth was significantly lower compared with that for the preterm at term: the average global volume of intracranial volume (431.7 ± 69.98), total brain volume (391 ± 66,1), cortical gray matter (179 mL ± 41.54), unmyelinated white matter (185.3 mL ± 30.8), and myelinated white matter (10.66 mL ± 3.05). It was also lower compared with that of full-term infants: intracranial volume (427.4 mL ± 53.84), total brain volume (394 ± 49.22), cortical gray matter (181.4 ± 29.27), unmyelinated white matter (183.4 ± 27.37), and myelinated white matter (10.72 ± 4.63). The relative volume of cortical gray matter (30.62 ± 5.13) and of unmyelinated white matter (53.15 ± 4.8) for preterm at birth was significantly different compared with the relative volume of cortical gray matter (41.05 ± 5.44) and of unmyelinated white matter (43.22 ± 5.11) for the preterm at term. Premature infants had similar brain tissue volumes at 40 weeks to full-term infants.

CONCLUSION: MR segmentation techniques demonstrate that cortical neonatal maturation in moderately premature infants at term and term-born infants was similar.