Multimodal MRI Techniques Reveal Brain Iron Deposition and Glymphatic Dysfunction in newborns with Hypoxic-Ischemic Encephalopathy.

RATIONALE AND

OBJECTIVE

To investigate the cerebral iron content and glymphatic function in newborns with HIE.

METHODS

A total of 57 newborns with HIE, aged 1-28 days, were prospectively selected to constitute the HIE group. Meanwhile, 50 healthy newborns were selected as the control group. All the newborns underwent T1 Flair, T2 Flair, 3D-T1, ESWAN, and DTI sequence scans. Subsequently, software processing was performed to obtain the QSM values reflecting iron contents in brain regions and the DTI-ALPS values evaluating the function of glymphatic system. Comparative analysis of the QSM and DTI-ALPS values between the two groups were carried out to identify the characteristic parameters in the brain regions of newborns with HIE. ROC curve analysis was then utilized to detect the sensitivity of QSM value and DTI-ALPS index.

RESULTS

In newborns with HIE, the QSM values in the frontal lobe, temporal lobe, and basal ganglia were significantly elevated (P < 0.05). the DTI-ALPS values were notably decreased (P < 0.05). The QSM values in different brain regions such as the frontal lobe, temporal lobe, and basal ganglia were respectively negative correlated with the DTI-ALPS value. The QSM values of the frontal lobe, temporal lobe and basal ganglia, in combination with the DTI-ALPS values, facilitated the discrimination of newborns with HIE from those in the control group (P < 0.05).

CONCLUSION

In newborns with HIE, a significant increase in brain iron content was manifested, concomitant with a compromised glymphatic dysfunction. KEY POINTS AND CLINICAL RELEVANCE STATEMENT.