Serial quantitative diffusion tensor MRI of the premature brain: Development in newborns with and without injury

Purpose: To determine the change over time of the apparent diffusion coefficient (ADC) and relative anisotropy of cerebral water in a cohort of premature newborns serially studied near birth and again near term. Materials and Methods: Newborns were classified as normal (N = 11), minimal white matter injury (N = 7), or moderate white matter injury (N = 5). Results: ADC decreased significantly with age in all brain regions in newborns classified as normal and those with minimal white matter injury. ADC increased with age or failed to decline in widespread areas of white matter in newborns with moderate white matter injury. Anisotropy increased with age in all white matter regions in newborns classified as normal. Anisotropy did not increase in frontal white matter in those with minimal white matter injury, and in widespread white matter areas in those with moderate white matter injury. Conclusion: This study demonstrates that serial diffusion tensor magnetic resonance imaging scans,of premature newborns can detect differences in white matter maturation in infants with and without white matter injury.