Microstructural Alterations in Projection and Association Fibers in Neonatal Hypoxia–Ischemia

Background Diffusion MRI (dMRI) is known to be sensitive to hypoxic–ischemic encephalopathy (HIE). However, existing dMRI studies used simple diffusion tensor metrics and focused only on a few selected cerebral regions, which cannot provide a comprehensive picture of microstructural injury. Purpose...

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Bibliographic Details
Published in:Journal of magnetic resonance imaging 2023-04, Vol.57 (4), p.1131-1142
Main Authors: Cao, Zuozhen, Lin, Huijia, Gao, Fusheng, Shen, Xiaoxia, Zhang, Hongxi, Zhang, Jiangyang, Du, Lizhong, Lai, Can, Ma, Xiaolu, Wu, Dan
Format: Article
Language:English
Subjects:
Anisotropy
Body weight
Brain damage
Corpus callosum
Density
Diffusion
Diffusion Magnetic Resonance Imaging
diffusion MRI
Diffusion Tensor Imaging - methods
Diffusivity
Encephalopathy
Female
Fibers
Field strength
fixel
Hemispheric laterality
Humans
Hypoxia
Hypoxia-Ischemia, Brain
hypoxic–ischemic encephalopathy
Image processing
Infant, Newborn
Injury prevention
Ischemia
Magnetic resonance imaging
Male
microstructural alternation
Neonates
Population studies
Prospective Studies
Radiation
region of interest
Statistical analysis
Statistical tests
Substantia alba
Tensors
Thalamus
tract
Watersheds
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Summary:Background Diffusion MRI (dMRI) is known to be sensitive to hypoxic–ischemic encephalopathy (HIE). However, existing dMRI studies used simple diffusion tensor metrics and focused only on a few selected cerebral regions, which cannot provide a comprehensive picture of microstructural injury. Purpose To systematically characterize the microstructural alterations in mild, moderate, and severe HIE neonates compared to healthy neonates with advanced dMRI using region of interest (ROI), tract, and fixel‐based analyses. Study Type Prospective. Population A total of 42 neonates (24 males and 18 females). Field Strength/Sequence 3‐T, diffusion‐weighted echo‐planar imaging. Assessment Fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), axial diffusivity (AD), fiber density (FD), fiber cross‐section (FC), and fiber density and cross‐section (FDC) were calculated in 40 ROIs and 6 tracts. Fixel‐based analysis was performed to assess group differences in individual fiber components within a voxel (fixel). Statistical Tests One‐way analysis of covariance (ANCOVA) to compare dMRI metrics among severe/moderate/mild HIE and control groups and general linear model for fixel‐wise group differences (age, sex, and body weight as covariates). Adjusted P value 
ISSN:1053-1807
1522-2586
DOI:10.1002/jmri.28366