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Research ArticlePediatrics

Different from the Beginning: WM Maturity of Female and Male Extremely Preterm Neonates—A Quantitative MRI Study

V.U. Schmidbauer, M.S. Yildirim, G.O. Dovjak, K. Goeral, J. Buchmayer, M. Weber, M.C. Diogo, V. Giordano, G. Mayr-Geisl, F. Prayer, M. Stuempflen, F. Lindenlaub, V. List, S. Glatter, A. Rauscher, F. Stuhr, C. Lindner, K. Klebermass-Schrehof, A. Berger, D. Prayer and G. Kasprian
American Journal of Neuroradiology April 2022, 43 (4) 611-619; DOI: https://doi.org/10.3174/ajnr.A7472
V.U. Schmidbauer
aFrom the Department of Biomedical Imaging and Image-guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., F.P., M.S., F.L., F.S., C.L., D.P., G.K.)
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M.S. Yildirim
aFrom the Department of Biomedical Imaging and Image-guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., F.P., M.S., F.L., F.S., C.L., D.P., G.K.)
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G.O. Dovjak
aFrom the Department of Biomedical Imaging and Image-guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., F.P., M.S., F.L., F.S., C.L., D.P., G.K.)
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K. Goeral
bComprehensive Center for Pediatrics (K.G., J.B., V.G., V.L., S.G., K.K.-S., A.B.), Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics
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J. Buchmayer
bComprehensive Center for Pediatrics (K.G., J.B., V.G., V.L., S.G., K.K.-S., A.B.), Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics
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M. Weber
aFrom the Department of Biomedical Imaging and Image-guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., F.P., M.S., F.L., F.S., C.L., D.P., G.K.)
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M.C. Diogo
dDepartment of Neuroradiology (M.C.D.), Hospital Garcia de Orta, Almada, Portugal
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V. Giordano
bComprehensive Center for Pediatrics (K.G., J.B., V.G., V.L., S.G., K.K.-S., A.B.), Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics
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G. Mayr-Geisl
cDepartment of Neurosurgery (G.M.-G.), Medical University of Vienna, Vienna, Austria
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F. Prayer
aFrom the Department of Biomedical Imaging and Image-guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., F.P., M.S., F.L., F.S., C.L., D.P., G.K.)
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M. Stuempflen
aFrom the Department of Biomedical Imaging and Image-guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., F.P., M.S., F.L., F.S., C.L., D.P., G.K.)
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F. Lindenlaub
aFrom the Department of Biomedical Imaging and Image-guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., F.P., M.S., F.L., F.S., C.L., D.P., G.K.)
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V. List
bComprehensive Center for Pediatrics (K.G., J.B., V.G., V.L., S.G., K.K.-S., A.B.), Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics
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S. Glatter
bComprehensive Center for Pediatrics (K.G., J.B., V.G., V.L., S.G., K.K.-S., A.B.), Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics
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A. Rauscher
eDepartment of Pediatrics (A.R.), University of British Columbia, Vancouver, British Columbia, Canada
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F. Stuhr
aFrom the Department of Biomedical Imaging and Image-guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., F.P., M.S., F.L., F.S., C.L., D.P., G.K.)
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C. Lindner
aFrom the Department of Biomedical Imaging and Image-guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., F.P., M.S., F.L., F.S., C.L., D.P., G.K.)
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K. Klebermass-Schrehof
bComprehensive Center for Pediatrics (K.G., J.B., V.G., V.L., S.G., K.K.-S., A.B.), Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics
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A. Berger
bComprehensive Center for Pediatrics (K.G., J.B., V.G., V.L., S.G., K.K.-S., A.B.), Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics
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D. Prayer
aFrom the Department of Biomedical Imaging and Image-guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., F.P., M.S., F.L., F.S., C.L., D.P., G.K.)
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G. Kasprian
aFrom the Department of Biomedical Imaging and Image-guided Therapy (V.U.S., M.S.Y., G.O.D., M.W., F.P., M.S., F.L., F.S., C.L., D.P., G.K.)
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Abstract

BACKGROUND AND PURPOSE: Former preterm born males are at higher risk for neurodevelopmental disabilities compared with female infants born at the same gestational age. This retrospective study investigated sex-related differences in the maturity of early myelinating brain regions in infants born <28 weeks’ gestational age using diffusion tensor– and relaxometry-based MR imaging.

MATERIALS AND METHODS: Quantitative MR imaging sequence acquisitions were analyzed in a sample of 35 extremely preterm neonates imaged at term-equivalent ages. Quantitative MR imaging metrics (fractional anisotropy; ADC [10−3mm2/s]; and T1-/T2-relaxation times [ms]) of the medulla oblongata, pontine tegmentum, midbrain, and the right/left posterior limbs of the internal capsule were determined on diffusion tensor– and multidynamic, multiecho sequence–based imaging data. ANCOVA and a paired t test were used to compare female and male infants and to detect hemispheric developmental asymmetries.

RESULTS: Seventeen female (mean gestational age at birth: 26 + 0 [SD, 1 + 4] weeks+days) and 18 male (mean gestational age at birth: 26 + 1 [SD, 1 + 3] weeks+days) infants were enrolled in this study. Significant differences were observed in the T2-relaxation time (P = .014) of the pontine tegmentum, T1-relaxation time (P = .011)/T2-relaxation time (P = .024) of the midbrain, and T1-relaxation time (P = .032) of the left posterior limb of the internal capsule. In both sexes, fractional anisotropy (P [♀] < .001/P [♂] < .001) and ADC (P [♀] = .017/P [♂] = .028) differed significantly between the right and left posterior limbs of the internal capsule.

CONCLUSIONS: The combined use of various quantitative MR imaging metrics detects sex-related and interhemispheric differences of WM maturity. The brainstem and the left posterior limb of the internal capsule of male preterm neonates are more immature compared with those of female infants at term-equivalent ages. Sex differences in WM maturation need further attention for the personalization of neonatal brain imaging.

ABBREVIATIONS:

FA
fractional anisotropy
GA
gestational age
ICC
intraclass correlation coefficient
MDME
multidynamic multiecho
PLIC
posterior limb of the internal capsule
PMA
postmenstrual age
T1R
T1-relaxation time
T2R
T2-relaxation time
  • © 2022 by American Journal of Neuroradiology
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American Journal of Neuroradiology: 43 (4)
American Journal of Neuroradiology
Vol. 43, Issue 4
1 Apr 2022
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Different from the Beginning: WM Maturity of Female and Male Extremely Preterm Neonates—A Quantitative MRI Study
V.U. Schmidbauer, M.S. Yildirim, G.O. Dovjak, K. Goeral, J. Buchmayer, M. Weber, M.C. Diogo, V. Giordano, G. Mayr-Geisl, F. Prayer, M. Stuempflen, F. Lindenlaub, V. List, S. Glatter, A. Rauscher, F. Stuhr, C. Lindner, K. Klebermass-Schrehof, A. Berger, D. Prayer, G. Kasprian
American Journal of Neuroradiology Apr 2022, 43 (4) 611-619; DOI: 10.3174/ajnr.A7472

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Different from the Beginning: WM Maturity of Female and Male Extremely Preterm Neonates—A Quantitative MRI Study
V.U. Schmidbauer, M.S. Yildirim, G.O. Dovjak, K. Goeral, J. Buchmayer, M. Weber, M.C. Diogo, V. Giordano, G. Mayr-Geisl, F. Prayer, M. Stuempflen, F. Lindenlaub, V. List, S. Glatter, A. Rauscher, F. Stuhr, C. Lindner, K. Klebermass-Schrehof, A. Berger, D. Prayer, G. Kasprian
American Journal of Neuroradiology Apr 2022, 43 (4) 611-619; DOI: 10.3174/ajnr.A7472
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