PT  - JOURNAL ARTICLE
AU  - X. Li
AU  - J. Gao
AU  - M. Wang
AU  - J. Zheng
AU  - Y. Li
AU  - E.S. Hui
AU  - M. Wan
AU  - J. Yang
TI  - Characterization of Extensive Microstructural Variations Associated with Punctate White Matter Lesions in Preterm Neonates
AID  - 10.3174/ajnr.A5226
DP  - 2017 Jun 01
TA  - American Journal of Neuroradiology
PG  - 1228--1234
VI  - 38
IP  - 6
4099  - http://www.ajnr.org/content/38/6/1228.short
4100  - http://www.ajnr.org/content/38/6/1228.full
SO  - Am. J. Neuroradiol.2017 Jun 01; 38
AB  - BACKGROUND AND PURPOSE: Punctate white matter lesions are common in preterm neonates. Neurodevelopmental outcomes of the neonates are related to the degree of extension. This study aimed to characterize the extent of microstructural variations for different punctate white matter lesion grades.MATERIALS AND METHODS: Preterm neonates with punctate white matter lesions were divided into 3 grades (from mild to severe: grades I–III). DTI-derived fractional anisotropy, axial diffusivity, and radial diffusivity between patients with punctate white matter lesions and controls were compared with Tract-Based Spatial Statistics and tract-quantification methods.RESULTS: Thirty-three preterm neonates with punctate white matter lesions and 33 matched controls were enrolled. There were 15, 9, and 9 patients, respectively, in grades I, II, and III. Punctate white matter lesions were mainly located in white matter adjacent to the lateral ventricles, especially regions lateral to the trigone, posterior horns, and centrum semiovale and/or corona radiata. Extensive microstructural changes were observed in neonates with grade III punctate white matter lesions, while no significant changes in DTI metrics were found for grades I and II. A pattern of increased axial diffusivity, increased radial diffusivity, and reduced/unchanged fractional anisotropy was found in regions adjacent to punctate white matter lesion sites seen on T1WI and T2WI. Unchanged axial diffusivity, increased radial diffusivity, and reduced/unchanged fractional anisotropy were observed in regions distant from punctate white matter lesion sites.CONCLUSIONS: White matter microstructural variations were different across punctate white matter lesion grades. Extensive change patterns varied according to the distance to the lesion sites in neonates with severe punctate white matter lesions. These findings may help in determining the outcomes of punctate white matter lesions and selecting treatment strategies.ADaxial diffusivityCSTcorticospinal tractFAfractional anisotropyGCCgenu of the corpus callosumIFOinferior fronto-occipital fasciculusORoptic radiationPWMLpunctate white matter lesionRDradial diffusivitySCCsplenium of corpus callosum