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American Academy of Pediatrics
Article

Diffusion-Weighted Imaging of the Brain in Preterm Infants With Focal and Diffuse White Matter Abnormality

Serena J. Counsell, Joanna M. Allsop, Michael C. Harrison, David J. Larkman, Nigel L. Kennea, Olga Kapellou, Frances M. Cowan, Joseph V. Hajnal, A. David Edwards and Mary A. Rutherford
Pediatrics July 2003, 112 (1) 1-7; DOI: https://doi.org/10.1542/peds.112.1.1
Serena J. Counsell
*Robert Steiner Magnetic Resonance Unit, Imaging Sciences Department, MRC Clinical Sciences Centre
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Joanna M. Allsop
*Robert Steiner Magnetic Resonance Unit, Imaging Sciences Department, MRC Clinical Sciences Centre
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Michael C. Harrison
‡Department of Paediatrics, Faculty of Medicine, Imperial College, Hammersmith Campus, London, United Kingdom
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David J. Larkman
*Robert Steiner Magnetic Resonance Unit, Imaging Sciences Department, MRC Clinical Sciences Centre
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Nigel L. Kennea
‡Department of Paediatrics, Faculty of Medicine, Imperial College, Hammersmith Campus, London, United Kingdom
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Olga Kapellou
‡Department of Paediatrics, Faculty of Medicine, Imperial College, Hammersmith Campus, London, United Kingdom
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Frances M. Cowan
‡Department of Paediatrics, Faculty of Medicine, Imperial College, Hammersmith Campus, London, United Kingdom
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Joseph V. Hajnal
*Robert Steiner Magnetic Resonance Unit, Imaging Sciences Department, MRC Clinical Sciences Centre
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A. David Edwards
*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
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Mary A. Rutherford
*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
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Abstract

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.

  • magnetic resonance imaging
  • diffusion weighted imaging
  • DEHSI
  • preterm
  • brain
  • Received September 11, 2002.
  • Accepted December 20, 2002.
  • Copyright © 2003 by the American Academy of Pediatrics

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Pediatrics
Vol. 112, Issue 1
1 Jul 2003
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Diffusion-Weighted Imaging of the Brain in Preterm Infants With Focal and Diffuse White Matter Abnormality
Serena J. Counsell, Joanna M. Allsop, Michael C. Harrison, David J. Larkman, Nigel L. Kennea, Olga Kapellou, Frances M. Cowan, Joseph V. Hajnal, A. David Edwards, Mary A. Rutherford
Pediatrics Jul 2003, 112 (1) 1-7; DOI: 10.1542/peds.112.1.1

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Diffusion-Weighted Imaging of the Brain in Preterm Infants With Focal and Diffuse White Matter Abnormality
Serena J. Counsell, Joanna M. Allsop, Michael C. Harrison, David J. Larkman, Nigel L. Kennea, Olga Kapellou, Frances M. Cowan, Joseph V. Hajnal, A. David Edwards, Mary A. Rutherford
Pediatrics Jul 2003, 112 (1) 1-7; DOI: 10.1542/peds.112.1.1
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Subjects

  • Fetus/Newborn Infant
    • Fetus/Newborn Infant

Keywords

  • magnetic resonance imaging
  • diffusion weighted imaging
  • DEHSI
  • preterm
  • brain
  • 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
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