Diffusion Tensor Imaging Analysis of White Matter Microstructural Integrity in Infants With Retinopathy of Prematurity.

PURPOSE: To investigate white matter maturation in preterm infants with and without retinopathy of prematurity (ROP) and to determine whether ROP is associated with white matter microstructural integrity at term-equivalent ages.

METHODS

In 82 preterm and 34 full-term infants who had undergone brain magnetic resonance imaging diffusion tensor imaging at term-equivalent ages, white matter microstructural integrity was assessed based on mean fractional anisotropy (FA) and mean diffusivity (MD) values in 23 predefined regions of interest by using atlas-based analyses. The values were compared among preterm and full-term infants, and a general linear model was used to evaluate the association of the values with ROP or severe (i.e., stage ≥3) ROP.

RESULTS

Significant differences in FA and MD values were observed among preterm and full-term infants in 17 (73.9%) and 15 (65.2%) of the 23 white matter areas evaluated, respectively. However, ROP was significantly associated with MD values in only two areas (superior longitudinal fasciculus [P = 0.030] and cerebral peduncle [P = 0.005]). Severe ROP was significantly associated with FA values within the anterior limb of the internal capsule (P = 0.049) and MD values within the stria terminalis (P = 0.035). A network analysis showed that preterm infants with severe ROP had lower small-world index values than those without.

CONCLUSIONS

Preterm birth may be more strongly associated with white matter maturation at term-equivalent ages than ROP, but severe ROP may be associated with decreased structural connectivity.