Efficiency of fractional anisotropy and apparent diffusion coefficient on diffusion tensor imaging in prognosis of neonates with hypoxic-ischemic encephalopathy: a methodologic prospective pilot study.
AJNR Am J Neuroradiol. 2009-12-03; 31(2): 282-287
DOI: 10.3174/ajnr.A1805
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BACKGROUND AND PURPOSE: The DTI parameters (FA and ADC) reflect the properties of
the brain microstructure. Decreased anisotropy is a common feature of cerebral
tissue abnormalities. Our study investigates the neurologic prognostic efficiency
of these parameters in white (PLIC, CP) and gray matter (PP) in the first days of
life in term neonates with HIE. We hypothesize that lesions in related brain
areas could be part of a physiopathologic substratum supporting neurologic
deficiencies in this population.
MATERIALS AND METHODS: A total of 22 neonates (13 girls and 9 boys; mean
gestational age, 40 weeks +/- 9 days; birth weight, 3203 +/- 584 g) underwent
brain MR imaging between day 1 and day 6 after birth; 6-noncollinear direction
DTI was performed. FA and ADC were measured on specific brain areas. Amiel-Tison
score was performed on day 8.5 +/- 4 (group A, favorable outcome [n = 16]; group
B, unfavorable outcome [n = 6]).
RESULTS: Intraobserver and interobserver comparison in DTI parameter measurements
showed a coefficient of variability of less than 5%. In PLIC and PP, the ADC
values were lower in group B compared with group A (P = .000027), whereas in PLIC
and CP, the FA values were lower in group B compared with group A (P < .02).
CONCLUSIONS: These findings indicate that a poor early neurologic outcome in
neonates with HIE is associated with lower FA or ADC values in specific areas of
white or gray matter. The difference in ADC/FA changes in the different brain
areas explored may support possibly different pathologic processes.