PDF(Pubmed)
Abstract：
Diffusion Kurtosis Imaging (DKI)-derived metrics are recognized as indicators of maturation in neonates with low-grade germinal matrix and intraventricular hemorrhage (GMH-IVH). However, it is not yet known if these factors are associated with neurodevelopmental outcomes. The objective of this study was to acquire DKI-derived metrics in neonates with low-grade GMH-IVH, and to demonstrate their association with later neurodevelopmental outcomes. In this prospective study, neonates with low-grade GMH-IVH and control neonates were recruited, and DKI were performed between January 2020 and March 2021. These neonates underwent the Bayley Scales of Infant Development test at 18 months of age. Mean kurtosis (MK), radial kurtosis (RK) and gray matter values were measured. Spearman correlation analyses were conducted for the measured values and neurodevelopmental outcome scores. Forty controls (18 males, average gestational age (GA) 30 weeks ± 1.3, corrected GA at MRI scan 38 weeks ± 1) and thirty neonates with low-grade GMH-IVH (13 males, average GA 30 weeks ± 1.5, corrected GA at MRI scan 38 weeks ± 1). Neonates with low-grade GMH-IVH exhibited lower MK and RK values in the PLIC and the thalamus (P < 0.05). The MK value in the thalamus was associated with Mental Development Index (MDI) (r = 0.810, 95% CI 0.695-0.13; P < 0.001) and Psychomotor Development Index (PDI) (r = 0.852, 95% CI 0.722-0.912; P < 0.001) scores. RK value in the caudate nucleus significantly and positively correlated with MDI (r = 0.496, 95% CI 0.657-0.933; P < 0.001) and PDI (r = 0.545, 95% CI 0.712-0.942; P < 0.001) scores. The area under the curve (AUC) were used to assess diagnostic performance of MK and RK in thalamus (AUC = 0.866, 0.787) and caudate nucleus (AUC = 0.833, 0.671) for predicting neurodevelopmental outcomes. As quantitative neuroimaging markers, MK in thalamus and RK in caudate nucleus may help predict neurodevelopmental outcomes in neonates with low-grade GMH-IVH.
摘要：
弥散峰度成像（DKI）衍生的指标被认为是低级别生发基质和脑室内出血（GMH-IVH）新生儿成熟的指标。然而,目前尚不清楚这些因素是否与神经发育结局相关.这项研究的目的是获得低度GMH-IVH新生儿的DKI衍生指标，并证明它们与后来的神经发育结果的关联。在这项前瞻性研究中，招募低度GMH-IVH新生儿和对照新生儿，和DKI在2020年1月至2021年3月期间进行。这些新生儿在18个月大时接受了Bayley婴儿发育量表测试。平均峰度（MK），测量径向峰度（RK）和灰质值。对测量值和神经发育结果评分进行Spearman相关分析。40名对照（18名男性，平均胎龄（GA）30周±1.3，MRI扫描校正GA38周±1）和30例低度GMH-IVH新生儿（13例男性，平均GA30周±1.5，MRI扫描校正GA38周±1）。低度GMH-IVH的新生儿在PLIC和丘脑中的MK和RK值较低（P<0.05）。丘脑MK值与精神发育指数(MDI)(r=0.810,95%CI0.695-0.13;P<0.001)和精神运动发育指数(PDI)(r=0.852,95%CI0.722-0.912;P<0.001)评分相关。尾状核RK值与MDI评分(r=0.496,95%CI0.657~0.933,P<0.001)和PDI评分(r=0.545,95%CI0.712~0.942,P<0.001)呈显著正相关。曲线下面积（AUC）用于评估丘脑（AUC=0.866，0.787）和尾状核（AUC=0.833，0.671）中MK和RK的诊断性能，以预测神经发育结果。作为定量神经成像标志物，丘脑中的MK和尾状核中的RK可能有助于预测低度GMH-IVH新生儿的神经发育结果。
