Published online August 14, 2007
PEDIATRICS Vol. 120 No. 3 September 2007, pp. e604-e609 (doi:10.1542/peds.2006-3054)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Krishnan, M. L.
Right arrow Articles by Counsell, S. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Krishnan, M. L.
Right arrow Articles by Counsell, S. J.
Related Collections
Right arrow Neurology & Psychiatry
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

ARTICLE

Relationship Between White Matter Apparent Diffusion Coefficients in Preterm Infants at Term-Equivalent Age and Developmental Outcome at 2 Years

Michelle L. Krishnan, BSca, Leigh E. Dyet, MRCPCHa,b, James P. Boardman, PhD, MRCPCHa,b, Olga Kapellou, MRCPCHa,b, Joanna M. Allsop, DCRa, Frances Cowan, PhD, MRCPCHb, A. David Edwards, FMedScia,b, Mary A. Rutherford, MD, FRCRa,b and Serena J. Counsell, PhDa

a Robert Steiner Magnetic Resonance Unit
b Department of Paediatrics, Imaging Sciences Department, Medical Research Council Clinical Sciences Centre, Imperial College London, London, United Kingdom

OBJECTIVE. The aim of this study was to develop a simple reproducible method for the measurement of apparent diffusion coefficient values in the white matter of preterm infants using diffusion-weighted imaging to test the hypothesis that elevated mean apparent diffusion coefficient values are associated with lower developmental quotient scores at 2 years’ corrected age.

METHODS. We obtained diffusion-weighted imaging in 38 preterm infants at term-equivalent age who had no evidence of overt cerebral pathology on conventional MRI. Mean apparent diffusion coefficient values at the level of the centrum semiovale were determined. The children were assessed using a standardized neurologic examination, and the Griffiths Mental Development Scales were administered to obtain a developmental quotient at 2 years’ corrected age. The relationship between mean apparent diffusion coefficient values and developmental quotient was examined. Clinical data relating to postnatal sepsis, antenatal steroid exposure, supplemental oxygen, gender, patent ductus arteriosus, and inotrope requirement were collected, and the mean apparent diffusion coefficient values for each group were compared.

RESULTS. The mean (±SD) apparent diffusion coefficient value in the white matter was 1.385 ± 0.07 x 10–3 mm2/second, and the mean developmental quotient was 108.9 ± 11.5. None of the children had a significant neurologic problem. There was a significant negative correlation between mean apparent diffusion coefficient and developmental quotient.

CONCLUSION. These findings suggest that higher white matter apparent diffusion coefficient values at term-equivalent age in preterm infants without overt lesions are associated with poorer developmental performance in later childhood. Consequently, apparent diffusion coefficient values at term may be of prognostic value for neurodevelopmental outcome in infants who are born preterm and who have no other imaging indicators of abnormality.

Key Words: brain • preterm • diffusion-weighted imaging • neurodevelopmental outcome • MRI

Abbreviations: cPVL—cystic periventricular leukomalacia • HPI—hemorrhagic parenchymal infarction • DEHSI—diffuse excessive high-signal intensity • DWI—diffusion-weighted imaging • ADC—apparent diffusion coefficient • DQ—developmental quotient • GA—gestational age • TR—repetition time • TE—echo time • CSF—cerebrospinal fluid • ROI—regions of interest • PMA—postmenstrual age • GQ—generalized quotient

Accepted Jan 30, 2007.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 Am. J. Neuroradiol.Home page
J.L.Y. Cheong, D.K. Thompson, H.X. Wang, R.W. Hunt, P.J. Anderson, T.E. Inder, and L.W. Doyle
Abnormal White Matter Signal on MR Imaging Is Related to Abnormal Tissue Microstructure
AJNR Am. J. Neuroradiol., March 1, 2009; 30(3): 623 - 628.
[Abstract] [Full Text] [PDF]

Home page
 BrainHome page
S. J. Counsell, A. D. Edwards, A. T. M. Chew, M. Anjari, L. E. Dyet, L. Srinivasan, J. P. Boardman, J. M. Allsop, J. V. Hajnal, M. A. Rutherford, et al.
Specific relations between neurodevelopmental abilities and white matter microstructure in children born preterm
Brain, December 1, 2008; 131(12): 3201 - 3208.
[Abstract] [Full Text] [PDF]