Malik G K, Trivedi R, Gupta R K, Hasan K M, Hasan M, Gupta A, Pandey C M, Narayana P A
Department of Pediatrics, King George Medical University, Lucknow, UP, India.
Neuropediatrics. 2006 Dec;37(6):337-43. doi: 10.1055/s-2007-964869.
To determine the altered pattern of fractional anisotropy (FA) and mean diffusivity (MD) change in brain parenchyma in serially studied neonates with mild or moderate hypoxic ischemic injury (HIE) within 7 days after birth and again at the age of three months.
Serial diffusion tensor imaging (DTI) was performed at two-time points in term neonates with mild (n = 7) and moderate (n = 10) HIE and age/sex-matched controls (n = 7). Neurodevelopmental outcome was assessed at the time of the 2nd study.
On comparing FA and MD changes over time using two-way analysis of variance between neonates with HIE and controls, we observed significant differences in age-related FA increase (p < 0.05) in anterior limb of internal capsule and periventricular white matter of parietal, occipital, and temporal lobes. Significant differences in age-related MD decrease (p < 0.05) was observed in the caudate nuclei, and temporal white matter among these groups. Significant positive correlation was observed between neurodevelopmental outcome and FA.
The results suggest that abnormal FA and MD values help in early and more accurate assessment of microstructural damage in HIE that may have predictive value for long-term neurofunctional outcome in these neonates.
确定在出生后7天内以及三个月大时对患有轻度或中度缺氧缺血性脑损伤（HIE）的新生儿进行系列研究时，脑实质内分数各向异性（FA）和平均扩散率（MD）变化的改变模式。
对患有轻度（n = 7）和中度（n = 10）HIE的足月儿以及年龄/性别匹配的对照组（n = 7）在两个时间点进行系列扩散张量成像（DTI）。在第二次研究时评估神经发育结局。
使用HIE新生儿与对照组之间的双向方差分析比较FA和MD随时间的变化，我们观察到内囊前肢以及顶叶、枕叶和颞叶脑室周围白质中与年龄相关的FA增加存在显著差异（p < 0.05）。在这些组的尾状核和颞叶白质中观察到与年龄相关的MD降低存在显著差异（p < 0.05）。神经发育结局与FA之间存在显著正相关。
结果表明，异常的FA和MD值有助于早期更准确地评估HIE中的微观结构损伤，这可能对这些新生儿的长期神经功能结局具有预测价值。
