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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticlePediatrics

Quantitative Analysis of Punctate White Matter Lesions in Neonates Using Quantitative Susceptibility Mapping and R2* Relaxation

Y. Zhang, A. Rauscher, C. Kames and A.M. Weber
American Journal of Neuroradiology July 2019, 40 (7) 1221-1226; DOI: https://doi.org/10.3174/ajnr.A6114
Y. Zhang
aFrom the Department of Radiology (Y.Z.)
bMinistry of Education Key Laboratory of Child Development and Disorders (Y.Z.), Children's Hospital of Chongqing Medical University, Chongqing, P.R. China
cKey Laboratory of Pediatrics in Chongqing (Y.Z.), Chongqing, P.R. China
dChongqing International Science and Technology Cooperation Center for Child Development and Disorders (Y.Z.), Chongqing, P.R. China
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A. Rauscher
eDivision of Neurology (A.R., A.M.W.)
fDepartment of Pediatrics, University of British Columbia MRI Research Centre (A.R., A.M.W., C.K.)
gDepartments of Radiology, (A.R.)
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C. Kames
fDepartment of Pediatrics, University of British Columbia MRI Research Centre (A.R., A.M.W., C.K.)
hPhysics and Astronomy (C.K.), University of British Columbia, Vancouver, British Columbia, Canada.
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A.M. Weber
eDivision of Neurology (A.R., A.M.W.)
fDepartment of Pediatrics, University of British Columbia MRI Research Centre (A.R., A.M.W., C.K.)
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  • Fig 1.
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    Fig 1.

    A–D, Punctate white matter lesions in a term neonate born at 38 weeks' gestational age, scanned at 40 weeks' gestational age (corresponding to case 2 in Table 3). A, T1-weighted axial image shows isolated high-intensity spots (arrows) corresponding to punctate white matter lesions in the white matter of the left frontal lobe and right posterior periventricular white matter. B, Corresponding T2-weighted axial image. Low-intensity spots (arrows) correspond to punctate lesions. C, R2* shows high signal in the punctate white matter lesions (arrows). D, QSM shows high signal at the punctate white matter lesions (arrows). E–H, Focal hemorrhagic lesions in a preterm neonate born at 35 weeks' gestational age, scanned at 38 weeks' gestational age (corresponding to case 6 in Table 3). E, T1-weighted axial image shows isolated high-intensity spots (arrows) corresponding to focal hemorrhagic lesions in the bilateral cerebellar hemispheres. F, Corresponding T2-weighted axial image. Low-intensity spots (arrows) correspond to focal hemorrhagic lesions, G and H, R2* and QSM, respectively, show very high signal at the focal hemorrhagic lesions (arrows), indicative of paramagnetic hemorrhagic products. I–L, Punctate white matter lesions in a preterm neonate born at 31 weeks' gestational age, scanned at 37 weeks' gestational age (corresponding to case 3 in Table 3). T1-weighted axial image (I), T2-weighted axial image (J), R2* (K), and QSM (L) through the body of the lateral ventricles show more punctate white matter lesions than the above term neonates in the 2 hemispheres (arrows). Lesions are linearly organized in the periventricular white matter.

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    Fig 2.

    The R2* (A) and susceptibility (B) values for the 3 tissue/lesion types for each subject (S1–S7).

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    Fig 3.

    Boxplots of R2* (A) and susceptibility (B) values for the 3 tissue/lesion types.

Tables

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    Table 1:

    R2*—Dunn Kruskal-Wallis multiple comparisonsa

    ComparisonZP.unadjP.adj
    CC FH−5.884.05e–091.21e–08
    CC PWML−4.242.19e–054.38e–05
    FH PWML2.401.64e–021.64e–02
    • Note:—P.unadj indicates unadjusted P values; P.adj, adjusted P values; CC, corpus callosum; FH, focal hemorrhagic lesion.

    • ↵a P values were adjusted using the Bonferroni-Holm correction for multiple comparisons.

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    Table 2:

    QSM—Dunn Kruskal-Wallis multiple comparisonsa

    ComparisonZP.unadjP.adj
    CC FH−5.701.19e–083.58e–08
    CC PWML−3.751.75e–043.50e–04
    FH PWML2.619.04e–039.04e–03
    • Note:—P.unadj indicates unadjusted P values; P.adj, adjusted P values; CC, corpus callosum; FH, focal hemorrhagic lesion.

    • ↵a P values were adjusted using the Bonferroni-Holm correction for multiple comparisons.

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    Table 3:

    Clinical data and MR imaging findings in the study population

    No.GA (Birth) (wk)BW (g)ApgarSexScan Age (wk)PWMLFHIVH
    13937507Male4122Yes
    23836457Male4042Yes
    33115084Female3780No
    42812106Female3721Yes
    52911008Female3520No
    63527709Male3802No
    73414257Female3802No
    • Note:—GA indicates gestational age; BW, birth weight; Apgar, Apgar score (5 minutes); IVH, presence of intraventricular hemorrhage; FH, focal hemorrhagic lesion.

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    Table 4:

    The mean and SD of R2* and susceptibility in 3 groups

    ROIsCCPWMLsFH
    R2* (Hz)7.23 ± 1.5712.65 ± 1.9450.04 ± 11.42
    Susceptibility (ppm)0.0054 ± 0.00670.024 ± 0.0100.127 ± 0.039
    • Note:—CC indicates corpus callosum; FH, focal hemorrhagic lesion.

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American Journal of Neuroradiology: 40 (7)
American Journal of Neuroradiology
Vol. 40, Issue 7
1 Jul 2019
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Y. Zhang, A. Rauscher, C. Kames, A.M. Weber
Quantitative Analysis of Punctate White Matter Lesions in Neonates Using Quantitative Susceptibility Mapping and R2* Relaxation
American Journal of Neuroradiology Jul 2019, 40 (7) 1221-1226; DOI: 10.3174/ajnr.A6114

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Quantitative Analysis of Punctate White Matter Lesions in Neonates Using Quantitative Susceptibility Mapping and R2* Relaxation
Y. Zhang, A. Rauscher, C. Kames, A.M. Weber
American Journal of Neuroradiology Jul 2019, 40 (7) 1221-1226; DOI: 10.3174/ajnr.A6114
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