Malik Gyanendra K, Trivedi Richa, Gupta Amit, Singh Ritu, Prasad Kashi N, Gupta Rakesh K
Department of Pediatrics, King George's Medical University, Lucknow, Uttar Pradesh, India.
Brain Dev. 2008 May;30(5):334-41. doi: 10.1016/j.braindev.2007.10.002. Epub 2007 Nov 14.
Neonatal meningitis is one of the important causes of infant mortality and morbidity. Periventricular white matter of neonatal brain is known to be vulnerable to oxidative and hypoxic/ischemic injury secondary to neuro-infections. The aim of this study was to assess periventricular white matter damage in neonatal bacterial meningitis using diffusion tensor imaging (DTI). DTI was performed in 7 age/sex matched controls and 14 neonates with proven bacterial meningitis at the time of diagnosis and after 3 weeks of antibiotic treatment. Region of interest were placed on periventricular white matter to quantify fractional anisotropy (FA) and mean diffusivity (MD). Based on the clinical prognosis and conventional MRI, patients were grouped into those with normal and with abnormal outcome. Compared to controls significantly decreased FA values were observed in entire periventricular white matter except for left parietal white matter in patients with abnormal outcome. Even in those with normal outcome significant decrease in FA values were observed in right parietal and bilateral occipital white matter compared to controls. Decreased FA values in the periventricular white matter regions in neonatal meningitis confirm microstructural white matter injury.
新生儿脑膜炎是婴儿死亡和发病的重要原因之一。已知新生儿脑的脑室周围白质易受继发于神经感染的氧化和缺氧/缺血性损伤。本研究的目的是使用扩散张量成像（DTI）评估新生儿细菌性脑膜炎中的脑室周围白质损伤。在诊断时以及抗生素治疗3周后，对7名年龄/性别匹配的对照者和14名确诊为细菌性脑膜炎的新生儿进行了DTI检查。将感兴趣区置于脑室周围白质上，以量化各向异性分数（FA）和平均扩散率（MD）。根据临床预后和传统MRI，将患者分为预后正常和异常两组。与对照组相比，预后异常的患者除左侧顶叶白质外，整个脑室周围白质的FA值均显著降低。即使是预后正常的患者，与对照组相比，右侧顶叶和双侧枕叶白质的FA值也显著降低。新生儿脑膜炎脑室周围白质区域FA值降低证实了白质微观结构损伤。
