MR imaging of periventricular leukomalacia in childhood

Flodmark, Olof; Lupton, Brian A.; Li, D; Stimac, Gary K.; Roland, Elke H.; Hill, Alan; Whitfield, Michael F.; Norman, M. G.

doi:10.2214/ajr.152.3.583

Cited by 96 publications

(61 citation statements)

References 14 publications

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“…[52][53][54][55][56] Among the commissure fibers, the splenium of the corpus callosum and tapetum were most severely affected and are believed to contain commissural projections from the parietal, occipital, and temporal lobes. Combined with severe atrophy of the retrolenticular part of the internal capsule/posterior thalamic radiation, these results strongly suggest concentration of white matter injuries in the parietal and occipital white matter.…”

Section: Discussionmentioning

confidence: 99%

Diffusion Tensor Imaging in Children with Periventricular Leukomalacia: Variability of Injuries to White Matter Tracts

Nagae¹,

Hoon²,

Stashinko³

et al. 2007

American Journal of Neuroradiology

143

146

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BACKGROUND AND PURPOSE:Conventional MR imaging shows evidence of brain injury and/or maldevelopment in 70%-90% of children with cerebral palsy (CP), though its capability to identify specific white matter tract injury is limited. The great variability of white matter lesions in CP already demonstrated by postmortem studies is thought to be one of the reasons why response to treatment is so variable. Our hypothesis is that diffusion tensor imaging (DTI) is a suitable technique to provide in vivo characterization of specific white matter tract lesions in children with CP associated with periventricular leukomalacia (PVL).

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Section: Discussionmentioning

confidence: 99%

Diffusion Tensor Imaging in Children with Periventricular Leukomalacia: Variability of Injuries to White Matter Tracts

Nagae¹,

Hoon²,

Stashinko³

et al. 2007

American Journal of Neuroradiology

143

146

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“…The radiologists were blinded to which group a child belonged. They used published criteria for diagnosis (23) and graded the severity of PVL on a scale from 0 to 3, where 0 ϭ no; 1 ϭ mild; 2 ϭ moderate; and 3 ϭ severe. Each radiologist identified three children in the preterm group to have signs of PVL.…”

Section: Subjectsmentioning

confidence: 99%

Preterm Children Have Disturbances of White Matter at 11 Years of Age as Shown by Diffusion Tensor Imaging

et al. 2003

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Preterm birth frequently involves white matter injury and affects long-term neurologic and cognitive outcomes. Diffusion tensor imaging has been used to show that the white matter microstructure of newborn, preterm children is compromised in a regionally specific manner. However, until now it was not clear whether these lesions would persist and be detectible on longterm follow-up. Hence, we collected diffusion tensor imaging data on a 1.5-T scanner, and computed fractional anisotropy and coherence measures to compare the white matter integrity of children born preterm to that of control subjects. The subjects for the preterm group (10.9 Ϯ 0.29 y; n ϭ 9; birth weight Յ 1500 g; mean gestational age, 28.6 Ϯ 1.05 wk) possessed attention deficits, a common problem in preterms. They were compared with age-and sex-matched control children (10.8 Ϯ 0.33 y; n ϭ 10; birth weight Ն 2500; gestational age, Ն 37 wk). We found that the preterm group had lower fractional anisotropy values in the posterior corpus callosum and bilaterally in the internal capsules. In the posterior corpus callosum this difference in fractional anisotropy values may partially be related to a difference in white matter volume between the groups. An analysis of the coherence measure failed to indicate a group difference in the axonal organization. These results are in agreement with previous diffusion tensor imaging findings in newborn preterm children, and indicate that ex-preterm children with attention deficits have white matter disturbances that are not compensated for or repaired before 11 y of age. Preterm birth, and the early exposure to the extrauterine environment, increases the risks of perinatal brain injury (1, 2). Often these injuries involve the white matter (2, 3) and affect long-term neurologic and cognitive outcome, including problems with attention (4 -8). These long-term effects of perinatal complications are either a result of the inability to repair the original lesions, such as PVL, or caused by a disruption of the maturational processes.DTI is a relatively recent method of MRI. From the fact that the preferential direction of water diffusion within the white matter of the brain occurs along the axons, this technique identifies white matter and indicates the direction of the fiber bundles within (9). In the absence of restriction, water diffusion is spatially uniform (i.e. isotropic). However, depending on the number, size, arrangement, and density of axons, as well as on the extent of myelination, water diffusion in the brain deviates from spherical and approaches the shape of an ellipsoid (i.e. anisotropic diffusion) with the long axis pointing along the axons [for a review, see Westin et al. (10)]. Therefore DTI provides information on the microstructure of white matter. To estimate the extent of anisotropy we calculated FA, which ranges in value between 0 and 1 for isotropic and onedimensional diffusion, respectively (11).Several studies have used conventional MRI to investigate the immediate effects of brain injury in prete...

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“…PVL arises in mid-gestation at a point when myelination is initiating (4). Injury of white matter glial cells is prevalent and may involve selective loss of oligodendroglia with subsequent hypomyelination (5)(6)(7).…”

mentioning

confidence: 99%

Acute Lipopolysaccharide-Mediated Injury in Neonatal White Matter Glia: Role of TNF-α, IL-1β, and Calcium

Sherwin

Fern

2005

The Journal of Immunology

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Bacterial infection is implicated in the selective CNS white matter injury associated with cerebral palsy, a common birth disorder. Exposure to the bacterial endotoxin LPS produced death of white matter glial cells in isolated neonatal rat optic nerve (RON) (a model white matter tract), over a 180-min time course. A delayed intracellular Ca2+ concentration ([Ca2+]i) rise preceded cell death and both events were prevented by removing extracellular Ca2+. The cytokines TNF-α or IL-1β, but not IL-6, mimicked the cytotoxic effect of LPS, whereas blocking either TNF-α with a neutralizing Ab or IL-1 with recombinant antagonist prevented LPS cytotoxicity. Ultrastructural examination showed wide-scale oligodendroglial cell death in LPS-treated rat optic nerves, with preservation of astrocytes and axons. Fluorescently conjugated LPS revealed LPS binding on microglia and astrocytes in neonatal white and gray matter. Astrocyte binding predominated, and was particularly intense around blood vessels. LPS can therefore bind directly to developing white matter astrocytes and microglia to evoke rapid cell death in neighboring oligodendroglia via a calcium- and cytokine-mediated pathway. In addition to direct toxicity, LPS increased the degree of acute cell death evoked by ischemia in a calcium-dependent manner.

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MR imaging of periventricular leukomalacia in childhood

Cited by 96 publications

References 14 publications

Diffusion Tensor Imaging in Children with Periventricular Leukomalacia: Variability of Injuries to White Matter Tracts

Diffusion Tensor Imaging in Children with Periventricular Leukomalacia: Variability of Injuries to White Matter Tracts

Preterm Children Have Disturbances of White Matter at 11 Years of Age as Shown by Diffusion Tensor Imaging

Acute Lipopolysaccharide-Mediated Injury in Neonatal White Matter Glia: Role of TNF-α, IL-1β, and Calcium

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