Choi Arum, Bak Dayeon, Kim Jimin, Oh Se Won, Nam Yoonho, Kim Hyun Gi
Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea.
Korean J Radiol. 2025 Aug;26(8):782-792. doi: 10.3348/kjr.2025.0300.
To evaluate the association between hypoxic-ischemic injury (HII) of the brain and glymphatic function using MRI-derived parameters in neonates.
This retrospective, single-institution study collected brain MRI scans of 127 neonates between July 2020 and July 2022. The volume and fraction of the basal ganglia perivascular space (BG-PVS) were automatically extracted using three-dimensional T2-weighted image processing. Diffusion-tensor imaging (DTI) along the PVS (DTI-ALPS) index values were derived from the DTI maps. BG-PVS and DTI-ALPS parameters were compared between neonates with and without HII. The correlations between MRI-derived glymphatic parameters and corrected gestational age (CGA), as well as between BG-PVS measurements and the DTI-ALPS index, were analyzed using Spearman coefficients. Multivariable logistic regression adjusted for age, sex, birth weight, and mode of delivery was performed to examine the associations between each glymphatic parameter and HII.
This study included 97 neonates without HII (median gestational age [GA]: 252 days) and 30 with HII (median GA: 252 days). Neonates with HII had smaller BG-PVS volumes (19 mm³ vs. 33 mm³, = 0.001) and fractions (0.29% vs. 0.54%, = 0.003) compared to neonates without HII. The DTI-ALPS index values did not differ significantly between neonates with and without HII ( = 0.54). CGA correlated negatively with BG-PVS measurements (ρ = -0.21 to -0.26, all < 0.05) and positively with DTI-ALPS index values (ρ = 0.22, = 0.014). BG-PVS measurements and DTI-ALPS index values were not significantly correlated (ρ = -0.28 to -0.08, all > 0.05). Multivariable logistic regression revealed a negative association between BG-PVS volume (odds ratio [OR]: 0.96 per mm³ increase, 95% confidence interval [CI]: 0.93-0.99) and fraction (OR: 0.15 per % increase, 95% CI: 0.03-0.79) with HII, while DTI-ALPS index values were not significantly associated with HII (OR: 0.10, 95% CI: 0.00-25.41).
Neonates with HII demonstrated smaller BG-PVS volume and fraction compared with those without HII, indicating potential alterations in glymphatic function among affected newborns.
利用MRI衍生参数评估新生儿脑缺氧缺血性损伤（HII）与类淋巴功能之间的关联。
这项回顾性单机构研究收集了2020年7月至2022年7月期间127例新生儿的脑部MRI扫描图像。使用三维T2加权图像处理自动提取基底节周围血管间隙（BG-PVS）的体积和分数。沿PVS的扩散张量成像（DTI）（DTI-ALPS）指数值由DTI图得出。比较有和没有HII的新生儿之间的BG-PVS和DTI-ALPS参数。使用Spearman系数分析MRI衍生的类淋巴参数与校正胎龄（CGA）之间的相关性，以及BG-PVS测量值与DTI-ALPS指数之间的相关性。进行了针对年龄、性别、出生体重和分娩方式调整的多变量逻辑回归分析，以检验每个类淋巴参数与HII之间的关联。
本研究纳入了97例无HII的新生儿（中位胎龄[GA]：252天）和30例有HII的新生儿（中位GA：252天）。与无HII的新生儿相比，有HII的新生儿BG-PVS体积更小（19mm³对33mm³，P = 0.001），分数更低（0.29%对0.54%，P = 0.003）。有和没有HII的新生儿之间DTI-ALPS指数值差异无统计学意义（P = 0.54）。CGA与BG-PVS测量值呈负相关（ρ = -0.21至-0.26，均P < 0.05），与DTI-ALPS指数值呈正相关（ρ = 0.22，P = 0.014）。BG-PVS测量值与DTI-ALPS指数值无显著相关性（ρ = -0.28至-0.08，均P > 0.05）。多变量逻辑回归显示BG-PVS体积（优势比[OR]：每增加1mm³为0.96，95%置信区间[CI]：0.93 - 0.99）和分数（OR：每增加1%为0.15，95%CI：0.03 - 0.79）与HII呈负相关，而DTI-ALPS指数值与HII无显著关联（OR：0.10，95%CI：0.00 - 25.41）。
与无HII的新生儿相比，有HII的新生儿BG-PVS体积和分数更小，表明受影响新生儿的类淋巴功能可能发生改变。
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