Of the Ministry of Health of the Russian Federation
Background Diffusion-tensor MRI and tractography allow to receive qualitative (visualisation) and quantitative tissue characteristics open new possibilities for studies of microstructure pathways of the brain in the process of its development.
Aim We established structural changes with the assessment pathways in the white matter of the brain using structural MRI, DTI and tractography in preterm infants with outcome in cerebral palsy.
patients and methods: Examined 18 patients with spastic forms of cerebral palsy (tetrapares – 12, diplegia – 4, hemipares – 2), who was born very premature (mean age at birth 29±2.5 weeks) with body weight at birth less than 1500 g. in the dynamics from 6 to 42 months. All patients underwent structural MRI and DTI (General Electric, USA, a tension of 3 and 1.5 Tesla). Quantitative (fractional anisotropy, FA) and qualitative data during commissural and corticospinal pathways were compared with matched for age and gender group of healthy children. Results: Structural MRI of all patients with cerebral palsy revealed periventricular changes of varying severity. According to DTI of patients with extremely low body mass at birth indicators FA of the corticospinal (0,17±0,04) and commissural fibres (0,24±0,08) was significantly lower compared with the group of neurologically healthy children (0,34±0,06 and 0.46±0,07, respectively). With repeated testing over 2 years in patients with cerebral palsy remained low indices FA of the corticospinal (0,29±0,02), and commissural (0,44±0,07) ways that were consistent with the presence of motor deficit, compared to a group of neurologically healthy children (0,39±0,06 and 0.5±0,08 respectively).
Conclusion In children with low body weight at birth low value FA during commissural and corticospinal pathways is a statistically significant predictor of the development of cerebral palsy, which is most apparent in 12–24 months later in patients with the development of the clinical picture of cerebral palsy.
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