Synthetic MRI demonstrates prolonged regional relaxation times in the brain of preterm born neonates with severe postnatal morbidity

Vanderhasselt, Tim; Zolfaghari, Roya; Naeyaert, Maarten; Dudink, Jeroen; Buls, Nico; Allemeersch, Gert‐Jan; Raeymaekers, Hubert; Cools, Filip; Mey, Johan De

doi:10.1016/j.nicl.2020.102544

Cited by 9 publications

(18 citation statements)

References 34 publications

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“…with the increasing GA (Figures 2 and 3 ). These findings were inconsistent with the study led by Vanderhasselt et al (2021), which found the obvious significance of PLIC.…”

Section: Discussioncontrasting

confidence: 95%

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Gestational age‐related changes in relaxation times of neonatal brain by quantitative synthetic magnetic resonance imaging

Dong

Deng²,

Xie

et al. 2023

Brain and Behavior

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Objective: This study aimed to explore the correlation between T1 and T2 relaxation times of synthetic MRI (SyMRI) and gestational age (GA) in each hemisphere of preterm and term newborns at the initial 28 days of birth. Methods: Seventy preterm and full-term infants were prospectively included in this study. All subjects completed 3.0 T routine MRI and SyMRI (MAGiC) one-stop scanning within 28 days of birth (aged 34-42 W at examination). The SyMRI postprocessing software (v8.0.4) was used to measure the T1 and T2 relaxation values of each brain region. The linear regression equations of quantitative relaxation values with GA were established to compare the variation speed in each brain region. Results: A significant linear and negative correlation was found between relaxation times and GA in the neonate cerebral cortex and subcortical gray and white matter regions (All p<.05). The relaxation time of the left centrum semiovale decreased with maximum variance with increasing GA among all white matter regions (T1: b = -51.45, β = -0.65, p < .0001; T2: b = -8.77, β = -0.71, p < .0001), whereas the right posterior limb of internal capsule showed minimal variance (T1: b = -27.94, β = -0.60, p < .0001; T2: b = -3.25, β = -0.68, p < .0001). Among all gray matter regions, the right globus pallidus and thalamus indicated the most significant decreasing degree of T1 and T2 relaxation values with GA (right globus pallidus T1: b = -33.14, β = -0.64, p < .0001; right thalamus T2: b = -3.94, β = -0.81, p < .0001), and the right and left occipital lobes indicated the least significant decreasing degree of T1 and T2 relaxation values with GA, respectively (right occipital lobes T1: b = -11.18, β = -0.26, p = .028; left occipital lobes T2: b = -1.22, β = -0.27, p = .024).Conclusions: SyMRI could quantitatively evaluate the linear changes of T1 and T2 relaxation values with GA in brain gray and white matter of preterm and term neonates.

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“…with the increasing GA (Figures 2 and 3 ). These findings were inconsistent with the study led by Vanderhasselt et al (2021), which found the obvious significance of PLIC.…”

Section: Discussioncontrasting

confidence: 95%

“…The accuracy and repeatability of quantitative measurements of relaxation time and PD value of brain tissue by SyMRI have been confirmed in previous studies (Krauss et al, 2015;Vanderhasselt et al, 2021;Vanderhasselt et al, 2020).…”

Section: Discussionsupporting

confidence: 73%

Gestational age‐related changes in relaxation times of neonatal brain by quantitative synthetic magnetic resonance imaging

Dong

Deng²,

Xie

et al. 2023

Brain and Behavior

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“…Measured values of CBF and relaxation time in most regions were correlated with corrected GA in our study. Regarding CBF, many studies have explored the associations between corrected GA and CBF 6,7,32 and between corrected GA and relaxation times, 12,13,15 and our study results are consistent with these previous findings. Cerebral blood flow has been seen to increase with corrected GA to reflect brain development 7 .…”

Section: Discussionsupporting

confidence: 93%

“…A recent study using synthetic MRI in preterm neonates showed higher T1 and T2 relaxation times in neonates with severe postnatal morbidities compared with those without morbidities. 15 Although the prior study did not show final neurodevelopmental outcomes, delayed maturation indicated by prolonged relaxation times in regional brain tissue was suggested as a prognostic marker for neurodevelopmental impairment. Our study results might differ from these past studies because of different patient characteristics.…”

Section: Discussionmentioning

confidence: 96%

“…With synthetic MRI, measurements can be done in reasonable scanning times, which has made it possible to apply this method to the pediatric population. Synthetic MRI studies in infants have already shown the potential of this tool, as they obtained T1 and T2 maps that reflected brain tissue maturation 15,16 . It is currently possible to evaluate delayed maturation in preterm neonates with synthetic MRI, and therefore, additional information can be gained compared with conventional structural sequences 16 .…”

mentioning

confidence: 99%

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Association of Cerebral Blood Flow and Brain Tissue Relaxation Time With Neurodevelopmental Outcomes of Preterm Neonates

Kim

Choi²,

Lee

et al. 2021

Invest Radiol

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ObjectivesBoth cerebral blood flow (CBF) and brain tissue relaxation times are known to reflect maturation in the neonatal brain. However, we do not yet know if these factors are associated with neurodevelopmental outcomes. The objective of this study was to acquire CBF and relaxation time in preterm neonates, using multidelay arterial spin labeling and synthetic magnetic resonance imaging (MRI), and show their association with later neurodevelopmental outcomes.Materials and MethodsIn this prospective study, preterm neonates were recruited, and multidelay arterial spin labeling and synthetic MRI were performed between September 2017 and December 2018. These neonates underwent the Bayley Scales of Infant Development test at 18 months of age, and both cognitive and motor outcome scores were measured. Transit time–corrected CBF and T1 and T2 relaxation time values were measured for different brain regions. The measured values were correlated with gestational age (GA) at birth and corrected GA at the MRI scan. Simple and multiple linear regression analyses were performed for the measured values and neurodevelopmental outcome scores.ResultsForty-nine neonates (median [interquartile range] GA, 30 [2] weeks, 209 [17] days; 28 boys) underwent MRI scans at or near term-equivalent age (median [interquartile range] corrected GA, 37 [2] weeks, 258 [14] days). Transit time–corrected CBF (coefficient, 0.31–0.59) and relaxation time (coefficient, −0.39 to −0.86) values showed significant correlation with corrected GA but not with GA. After controlling for GA, the frontal white matter CBF in preterm neonates showed a negative relationship with cognitive outcome scores (β = −0.97; P = 0.029). Frontal white matter T1 relaxation times showed a positive relationship with cognitive outcome scores (β = 0.03; P = 0.025) after controlling for GA.ConclusionsHigher CBF values and lower T1 relaxation times in frontal white matter were associated with poorer cognitive outcomes. As quantitative neuroimaging markers, CBF and relaxation times may help predict neurodevelopmental outcomes in preterm neonates.

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Synthetic magnetic resonance-based relaxometry and brain volume: cutoff values for predicting neurocognitive outcomes in very preterm infants

Vanderhasselt,

Naeyaert,

Buls

et al. 2024

Pediatr Radiol

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Background Early neurorehabilitation can enhance neurocognitive outcomes in very preterm infants (<32 weeks), and conventional magnetic resonance imaging (MRI) is commonly used to assess neonatal brain injury; however, the predictive value for neurodevelopmental delay is limited. Timely predictive quantitative biomarkers are needed to improve early identification and management of infants at risk of neurodevelopmental delay. Objective To evaluate the potential of quantitative synthetic MRI measurements at term-equivalent age as predictive biomarkers of neurodevelopmental impairment and establish practical cutoff values to guide clinical decision-making. Materials and methods This retrospective study included 93 very preterm infants who underwent synthetic MRI at term-equivalent age between January 2017 and September 2020. Clinical outcomes were assessed using the Bayley-III scale of infant development (mean age 2.1 years). The predictive value for impaired development was analyzed using receiver operating characteristic curves for synthetic MRI-based volumetry and T1 and T2 relaxation measurements. Results The T1 relaxation time in the posterior limb of the internal capsule was a potent predictor of severe (sensitivity, 92%; specificity, 80%; area under the curve (AUC), 0.91) and mild or severe (AUC, 0.75) developmental impairment. T2 relaxation time in the posterior limb of the internal capsule was a significant predictor of severe impairment (AUC, 0.76), whereas the brain parenchymal volume was a significant predictor of severe (AUC, 0.72) and mild or severe impairment (AUC, 0.71) outperforming the reported qualitative MRI scores (AUC, 0.66). Conclusion The proposed cutoff values for T1 relaxation time in the posterior limb of the internal capsule and for total brain volume measurements, derived from synthetic MRI, show promise as predictors of both mild and severe neurodevelopmental impairment in very preterm infants. Graphical Abstract

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Synthetic MRI demonstrates prolonged regional relaxation times in the brain of preterm born neonates with severe postnatal morbidity

Cited by 9 publications

References 34 publications

Gestational age‐related changes in relaxation times of neonatal brain by quantitative synthetic magnetic resonance imaging

Gestational age‐related changes in relaxation times of neonatal brain by quantitative synthetic magnetic resonance imaging

Association of Cerebral Blood Flow and Brain Tissue Relaxation Time With Neurodevelopmental Outcomes of Preterm Neonates

Synthetic magnetic resonance-based relaxometry and brain volume: cutoff values for predicting neurocognitive outcomes in very preterm infants

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