Abstract
Purpose
The long-term impact of low-grade germinal matrix-intraventricular hemorrhage (GMH-IVH) on brain perfusion has not been fully investigated. We aimed to compare cortical and deep gray matter (GM) cerebral blood flow (CBF) obtained with pseudo-continuous arterial spin labeling (pCASL), among preterm neonates with and without low-grade GMH-IVH and full-term controls.
Methods
3T-pCASL examinations of 9 healthy full-term neonates (mean gestational age 38.5 weeks, range 38–39) and 28 preterm neonates studied at term-equivalent age were analyzed. Eighteen preterm neonates presented normal brain MRI (mean gestational age 30.50 weeks, range 29–31) and 10 low-grade GMH-IVH according to Volpe’s grading system (mean gestational age 32 weeks, range 28–34). A ROI-based mean CBF quantification was performed in 5 cortical (frontal, parietal, temporal, insula, occipital), and 4 subcortical GM regions (caudate, putamen, pallidum, thalamus) for each cerebral hemisphere. CBF differences were explored using a nonparametric analysis of covariance.
Results
Low-grade GMH-IVH hemispheres showed consistently lower CBF in all GM regions when compared with healthy preterm neonates, after controlling the confounding effect of gestational age, postmenstrual age, and birth weight P < .001, η2 = .394. No significant differences were observed between neonates with low-grade GMH and full-term controls. Healthy preterm neonates showed significantly higher CBF than full-term controls in parietal (P = .032), temporal (P = .016), and occipital cortex (P = .024), and at level of thalamus (P = .023) and caudate nucleus (P = .014).
Conclusion
Low-grade GMH-IVH is associated with lower CBF in posterior cortical and subcortical gray matter regions in preterm neonates, suggesting regional vulnerability of these developing brain structures.
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Data Availability
Data used for the present analysis are available. For further information, please write to domenicotortora@gaslini.org.
Abbreviations
- ASL:
-
Arterial spin labeling
- CBF:
-
Cerebral blood flow
- GMH-IVH:
-
Germinal matrix and intraventricular hemorrhage
- HP:
-
Healthy preterm
- HT:
-
Healthy term
- pCASL:
-
Pseudo-continuous arterial spin labeling
- TEA:
-
Term-equivalent age
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Acknowledgments
This work was supported by Eu-Brain Non-profit Association, Genoa, Italy.
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This work was supported by funds from “Ricerca Corrente Disordini Neurologici e Muscolari (Linea 5)” of the Italian Ministry of Health.
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- Domenico Tortora: design of the study, data collection, data analysis, manuscript draft, revision of the manuscript
- Francesco Maria Lo Russo: data analysis, images preparation, revision of the manuscript
- Mariasavina Severino: manuscript draft, data collection, revision of the manuscript
- Alessandro Parodi: data collection, revision of the manuscript
- Paolo Massirio: data collection, revision of the manuscript
- Luca Antonio Ramenghi: data collection, revision of the manuscript
- Andrea Rossi: manuscript draft, revision of the manuscript, design of the study
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Tortora, D., Lo Russo, F.M., Severino, M. et al. Regional impairment of cortical and deep gray matter perfusion in preterm neonates with low-grade germinal matrix-intraventricular hemorrhage: an ASL study. Neuroradiology 62, 1689–1699 (2020). https://doi.org/10.1007/s00234-020-02514-9
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DOI: https://doi.org/10.1007/s00234-020-02514-9