Article Figures & Data
Figures
- Fig 1.
Region-of-interest templates and placements shown on FA maps. A, Anterior limb of the internal capsule, B, Posterior limb of the internal capsule. C and D, Corpus callosum, genu and splenium. E, Frontal periventricular zone. F, Occipital periventricular zone. G and H, Centrum semiovale at 2 consecutive levels. I, Subventricular zone (right-sided). The same templates were used for all scans.
- Fig 2.
Comparison of mean (SD) fractional anisotropy (A) and mean diffusivity (SD) (B) in term (white) and ELBW (gray) infants in selected regions of interest. Asterisk indicates P < .05; dagger, P < .01; ALIC, anterior limb of the internal capsule; PLIC, posterior limb of the internal capsule; FPVZ, frontal periventricular zone; OPVZ, occipital periventricular zone; CC, corpus callosum; CS, centrum semiovale; SVZ, subventricular zone.
Tables
Term (n = 12) (Mean) (SD) or (%) ELBW (n = 39) (Mean) (SD) or (%) Maternal age (yr) 23.6 (5.6) 27.9 (4.9)a GA at birth (wk) 38.6 (1.1) 25.6 (1.5)a Birth weight (g) 3159.8 (428.0) 768.6 (147.6)a PMA at MRI (wk) 38.9 (1.1) 38.4 (2.3) Male 33% 54% Race: white 42% 46% Private or mix of private/public medical insurance 33% 44% Maternal education: college degree or greater 50% 72% Antenatal steroids given (full course of betamethasone) N/A 62% Small for GA (<10th percentile) 0% 18%a Delivery room resuscitation Intubation at birth N/A 92% Resuscitation drug given N/A 3% Bronchopulmonary dysplasia N/A 85% Late-onset sepsis (± culture) N/A 67% Culture proven late-onset sepsis N/A 28% Necrotizing enterocolitis N/A 3% Major surgery (with general anesthesia) N/A 26% Severe retinopathy of prematurity N/A 21% White matter injury on cranial ultrasoundb N/A 21% Abnormal conventional MRI findings at termc N/A 66% Child's insurance status at time of follow-up Private 33% 37% Public medical insurance 67% 63% Household income ≥$50,000 at follow-up 33% 32% Note:—PMA indicates postmenstrual age; N/A, not applicable.
↵a P < .05.
↵b Defined as any presence of ventriculomegaly with or without blood in the ventricles, echodense lesions in the parenchyma, cystic periventricular leukomalacia, and/or a porencephalic cyst evident on cranial ultrasound prior to 28 days of life.
↵c Defined as the presence of signal abnormalities, brain atrophy, and/or abnormal gray matter or white matter maturation for age.
Developmental Outcome Term (n = 12) (Mean) (SD) or (%) ELBW (n = 39) (Mean) (SD) or (%) P Value Cerebral palsy 0% 10% N/A Bayley III mental scale score 96.4 (15.4) 88.5 (16.6) .16 Bayley III cognitive scale score 99.2 (17.8) 92.6 (15.3) .46 Bayley III language scale score 94.9 (16.4) 86.2 (18.6) .21 Note:—N/A indicates not applicable.
- Table 3:
Univariate analyses of DTI and clinical variables and their association with Bayley III scores at 18- to 22-months' corrected age in ELBW infants
Variable Mental Score Cognitive Score Language Score Coefficient (95% CI) P Coefficient (95% CI) P Coefficient (95% CI) P FA subventricular zone 179.4 (13.8–345.0) .04 219.4 (62.8–376.1) .01 141.1 (−57.1–339.2) .16 MD subventricular zone −18.9 (−33.4 to −4.3) .01 −17.5 (−32.0 to −3.1) .02 −20.2 (−37.1 to −3.3) .02 MD centrum semiovale −55.8 (−86.7 to −24.9) .001 −51.4 (−82.3 to −20.4) .002 −60.2 (−96.3 to −24.1) .002 Birth weight 0.01 (−0.02–0.1) .42 0.01 (−0.03–0.04) .80 0.01 (−0.03-.04) .80 White matter injury on cranial US −16.8 (−29.1 to −4.5) .01 −15.7 (−27.9 to −3.5) .01 −15.7 (−27.9 to −3.5) .01 Abnormal findings on conventional MRI −11.6 (−22.3 to −0.9) .03 −5.8 (−16.8–5.1) .29 −5.8 (−16.8 to 5.1) .29 Note:—US indicates ultrasound.
- Table 4:
Abnormalities in MD and FA and their association with Bayley III scores at 18–22 months corrected age in ELBW infants
Clinical/DTI Variable Coefficient (95% CI) P A) Mental scale score (adjusted R2 0.34/model P 0.001) MD centrum semiovale −45.7 (−75.6 to −15.7) .004 Birth weight 0.01 (−0.02–0.04) .41 White matter injury on ultrasound −12.5 (−23.9 to −1.0) .03 Abnormal MRI findings at term −5.0 (−14.9–4.8) .31 B) Language scale score (adjusted R2 0.37/model P 0.001) MD centrum semiovale −46.4 (−80.1 to −12.8) .01 Birth weight 0.02 (−0.02–0.054) .28 White matter injury on ultrasound −12.0 (−24.9–1.0) .07 Abnormal MRI at term −10.5 (−21.7–0.7) .07 C) Cognitive scale score (adjusted R2 0.30/model P 0.003) FA subventricular zone 244.6 (96.1–393.1) .002 Birth weight 0.01 (−0.02–0.05) .40 White matter injury on ultrasound −14.0 (−25.5 to −2.6) .02 Abnormal findings on MRI at term −5.5 (−15.6–4.6) .28
