White matter integrity on fractional anisotropy maps in encephalopathic neonates post hypothermia therapy with normal-appearing MR imaging

Background Neonatal encephalopathy (NE) is a clinically defined neurological syndrome commonly caused by ischemia. Objective We investigated white matter integrity in children with NE using diffusion tensor imaging (DTI) and examined the hypothesis that white matter insults not visible on convention...

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Bibliographic Details
Published in:Pediatric radiology 2013-06, Vol.43 (6), p.709-715
Main Authors: Lee, Earn Chun Christabel, Kwatra, Neha S., Vezina, Gilbert, Khademian, Zarir P.
Format: Article
Language:English
Subjects:
Anisotropy
Brain - pathology
Diffusion Tensor Imaging - methods
Epilepsy, Benign Neonatal - pathology
Epilepsy, Benign Neonatal - therapy
Female
Humans
Hypothermia, Induced - methods
Imaging
Infant, Newborn
Male
Medicine
Medicine & Public Health
Nerve Fibers, Myelinated - pathology
Neuroradiology
Nuclear Medicine
Oncology
Original Article
Pediatrics
Radiology
Treatment Outcome
Ultrasound
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Summary:Background Neonatal encephalopathy (NE) is a clinically defined neurological syndrome commonly caused by ischemia. Objective We investigated white matter integrity in children with NE using diffusion tensor imaging (DTI) and examined the hypothesis that white matter insults not visible on conventional MRI may have abnormal fractional anisotropy (FA) on DTI. Materials and methods DTI was performed on 36 term encephalopathic neonates who had hypothermia therapy. Of these, 12 neonates had normal conventional MRI findings (NNE) and 24 neonates had abnormal MRI findings (ANE). Twelve term-equivalent premature neonates with normal clinical neuroimaging and neurological function served as the control group. Results We found significant reductions in measured FA in white matter in the ANE neonates compared to the control group. There were, however, no significant differences in measured FA in white matter between the NNE and the control group. Conclusion We did not find white matter changes detectable by DTI in encephalopathic neonates post hypothermia with normal conventional MRI findings. Further studies would be required to determine whether this unexpected finding is a direct result of neuroprotective effects of hypothermia, or more sophisticated measures of FA are required to detect subtle white matter injury.
ISSN:0301-0449
1432-1998
DOI:10.1007/s00247-012-2572-2