





* Robert Steiner Magnetic Resonance Unit, Imaging Sciences Department, MRC Clinical Sciences Centre
Department of Paediatrics, Faculty of Medicine, Imperial College, Hammersmith Campus, London, United Kingdom
Objective. The most common finding on magnetic resonance imaging (MRI) of the brain in preterm infants at term-equivalent age is diffuse excessive high signal intensity (DEHSI) in the white matter. It is unclear whether DEHSI represents a biological abnormality. This study used diffusion-weighted imaging (DWI) to compare apparent diffusion coefficient (ADC) values in DEHSI with infants with normal imaging and those with overt brain damage to determine whether DEHSI shows the diffusion characteristics of normal or abnormal tissue.
Methods. MRI, using conventional and diffusion-weighted imaging (DWI), was performed in 50 preterm infants at term-equivalent age using a 1.5 Tesla MR scanner. The infants were divided into 3 groups on the basis of their MRI results: 1) normal white matter, 2) DEHSI, or 3) overt white matter pathology. ADC values were measured in the frontal, central, and posterior white matter at the level of the centrum semiovale. ADC values in the 3 groups of preterm infants were compared using a 1-way analysis of variance with a Bonferroni test for multiple comparisons.
Results. ADC values were significantly higher in infants with DEHSI and infants with overt white matter pathology than in infants with normal white matter. There was no significant difference between ADC values in infants with DEHSI and those with overt white matter pathology.
Conclusions. This study provides objective evidence that DEHSI represents diffuse white matter abnormality.
Key Words: magnetic resonance imaging diffusion weighted imaging DEHSI preterm brain
Abbreviations: PVL, periventricular leukomalacia PHI, periventricular hemorrhagic infarction IVH, intraventricular hemorrhage MRI, magnetic resonance imaging DEHSI, diffuse excessive high signal intensity DWI, diffusion-weighted imaging ADC, apparent diffusion coefficient GA, gestational age PMA, postmenstrual age CSE, conventional spin echo FSE, fast spin echo ROI, region of interest DTI, diffusion tensor imaging
This article has been cited by other articles:
![]() |
J Atkinson, O Braddick, S Anker, M Nardini, D Birtles, M A Rutherford, E Mercuri, L E Dyet, A D Edwards, and F M Cowan Cortical vision, MRI and developmental outcome in preterm infants Arch. Dis. Child. Fetal Neonatal Ed., July 1, 2008; 93(4): F292 - F297. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. J. Spittle, N. C. Brown, L. W. Doyle, R. N. Boyd, R. W. Hunt, M. Bear, and T. E. Inder Quality of General Movements Is Related to White Matter Pathology in Very Preterm Infants Pediatrics, May 1, 2008; 121(5): e1184 - e1189. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. Liauw, J. van der Grond, A. A. van den Berg-Huysmans, I. H. Palm-Meinders, M. A. van Buchem, and G. van Wezel-Meijler Hypoxic-Ischemic Encephalopathy: Diagnostic Value of Conventional MR Imaging Pulse Sequences in Term-born Neonates Radiology, April 1, 2008; 247(1): 204 - 212. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. J. Korzeniewski, G. Birbeck, M. C. DeLano, M. J. Potchen, and N. Paneth A Systematic Review of Neuroimaging for Cerebral Palsy J Child Neurol, February 1, 2008; 23(2): 216 - 227. [Abstract] [PDF] |
||||
![]() |
R. T. Constable, L. R. Ment, B. R. Vohr, S. R. Kesler, R. K. Fulbright, C. Lacadie, S. Delancy, K. H. Katz, K. C. Schneider, R. J. Schafer, et al. Prematurely Born Children Demonstrate White Matter Microstructural Differences at 12 Years of Age, Relative to Term Control Subjects: An Investigation of Group and Gender Effects Pediatrics, February 1, 2008; 121(2): 306 - 316. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. L. Krishnan, L. E. Dyet, J. P. Boardman, O. Kapellou, J. M. Allsop, F. Cowan, A. D. Edwards, M. A. Rutherford, and S. J. Counsell Relationship Between White Matter Apparent Diffusion Coefficients in Preterm Infants at Term-Equivalent Age and Developmental Outcome at 2 Years Pediatrics, September 1, 2007; 120(3): e604 - e609. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. Humphreys, R. Deonandan, S. Whiting, N. Barrowman, M.-A. Matzinger, V. Briggs, J. Hurteau, and E. Wallace Factors Associated With Epilepsy in Children With Periventricular Leukomalacia J Child Neurol, May 1, 2007; 22(5): 598 - 605. [Abstract] [PDF] |
||||
![]() |
L. Srinivasan, R. Dutta, S. J. Counsell, J. M. Allsop, J. P. Boardman, M. A. Rutherford, and A. D. Edwards Quantification of Deep Gray Matter in Preterm Infants at Term-Equivalent Age Using Manual Volumetry of 3-Tesla Magnetic Resonance Images Pediatrics, April 1, 2007; 119(4): 759 - 765. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. E. Dyet, N. Kennea, S. J. Counsell, E. F. Maalouf, M. Ajayi-Obe, P. J. Duggan, M. Harrison, J. M. Allsop, J. Hajnal, A. H. Herlihy, et al. Natural History of Brain Lesions in Extremely Preterm Infants Studied With Serial Magnetic Resonance Imaging From Birth and Neurodevelopmental Assessment Pediatrics, August 1, 2006; 118(2): 536 - 548. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. V. Covey and S. W. Levison Pathophysiology of Perinatal Hypoxia-Ischemia and the Prospects for Repair from Endogenous and Exogenous Stem Cells NeoReviews, July 1, 2006; 7(7): e353 - e362. [Full Text] [PDF] |
||||
![]() |
J. R. Duncan, M. L. Cock, K. Suzuki, J.-P. Y. Scheerlinck, R. Harding, and S. M. Rees Chronic Endotoxin Exposure Causes Brain Injury in the Ovine Fetus in the Absence of Hypoxemia Reproductive Sciences, February 1, 2006; 13(2): 87 - 96. [Abstract] [PDF] |
||||
![]() |
A. H. Hoon JR Neuroimaging in Cerebral Palsy: Patterns of Brain Dysgenesis and Injury J Child Neurol, December 1, 2005; 20(12): 936 - 939. [Abstract] [PDF] |
||||
![]() |
M. Judas, M. Rados, N. Jovanov-Milosevic, P. Hrabac, R. stern-Padovan, and I. Kostovic Structural, Immunocytochemical, and MR Imaging Properties of Periventricular Crossroads of Growing Cortical Pathways in Preterm Infants AJNR Am. J. Neuroradiol., November 1, 2005; 26(10): 2671 - 2684. [Abstract] [Full Text] [PDF] |
||||
![]() |
K J Rademaker, C S P M Uiterwaal, F J A Beek, I C van Haastert, A F Lieftink, F Groenendaal, D E Grobbee, and L S de Vries Neonatal cranial ultrasound versus MRI and neurodevelopmental outcome at school age in children born preterm Arch. Dis. Child. Fetal Neonatal Ed., November 1, 2005; 90(6): F489 - F493. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. J. Volpe Encephalopathy of Prematurity Includes Neuronal Abnormalities Pediatrics, July 1, 2005; 116(1): 221 - 225. [Full Text] [PDF] |
||||
![]() |
T. E. Inder, S. K. Warfield, H. Wang, P. S. Huppi, and J. J. Volpe Abnormal Cerebral Structure Is Present at Term in Premature Infants Pediatrics, February 1, 2005; 115(2): 286 - 294. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. J. Volpe Cerebral White Matter Injury of the Premature Infant--More Common Than You Think Pediatrics, July 1, 2003; 112(1): 176 - 180. [Full Text] [PDF] |
||||