White Matter Abnormalities Are Related to Microstructural Changes in Preterm Neonates at Term-Equivalent Age: A Diffusion Tensor Imaging and Probabilistic Tractography Study

BACKGROUND AND PURPOSE: Preterm infants have a high risk of brain injury and neurodevelopmental impairment, often associated with WMA on conventional MR imaging. DTI can provide insight into white matter microstructure. The aim of this study was to investigate the association between WMA on conventional MR imaging and DTI parameters in specific fibers in preterm neonates at term-equivalent age. MATERIALS AND METHODS: Seventy preterm neonates (39 boys and 31 girls) were included in the study. WMA were classified as no, mild, moderate, or severe. Probabilistic tractography provided tract volumes, FA, MD, lambda(sic), and lambda(perpendicular to) in the CST, SLF, TRs, and corpus callosum. Data were compared by using MANOVA, and adjustment for multiple comparisons was performed. RESULTS: Important associations were found between WMA and microstructural changes. Compared with neonates with no WMA (n = 41), those with mild WMA (n = 27) had significantly increased lambda(perpendicular to) and MD in the left ATR, the left sensory STR, the bilateral motor STR, and for lambda(perpendicular to) also in the right CST; FA decreased significantly in the left sensory STR. Diminished tract volumes and altered diffusion indices were also observed in the 2 neonates with moderate WMA. CONCLUSIONS: Altered DTI indices in specific tracts, with lambda(perpendicular to) as most prominent, are associated with mild WMA in preterm neonates at term-equivalent age.