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Tzarouchi LC 1 , Zikou AK 1 , Drougia L 2 , Astrakas LG 3 ,

Diffuse periventricular leukomalacia in preterm children: Assessment of grey matter changes by MRI. Tzarouchi LC 1 , Zikou AK 1 , Drougia L 2 , Astrakas LG 3 , Papastefanaki M 1 , Xydis V 1 , Andronikou S 2 , Argyropoulou MI 1 Department of Radiology

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Tzarouchi LC 1 , Zikou AK 1 , Drougia L 2 , Astrakas LG 3 ,

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  1. Diffuse periventricularleukomalacia in preterm children: Assessment of grey matter changes by MRI Tzarouchi LC1, Zikou AK1,Drougia L2 , Astrakas LG3, Papastefanaki M1, Xydis V1, Andronikou S2, Argyropoulou MI1 • Department of Radiology • Department of Medical Physics • Neonatology Clinic - Child Health Department Medical School, University of Ioannina GREECE

  2. Introduction Preterm birth periventricularleukomalacia Cognition: grey matter development • focal • diffuse motor deficits cognitive and behavioral deficits MRI studies * preterm reduced volumes in grey matter No distinction between focal/diffuse PVL Comparison with full-term • *Pediatrics 2007;119:759-765 • *Brain Doi:10.1093/brain/awm282 • * NeuroImage 2006;32:70-78 • *JAMA 2000;284:1939-47

  3. Purpose To assess in diffuse PVL regional volume of 116 grey matter (GM) areas

  4. Material & Methods I Study population 10 preterm children (9 males and 1 female) • gestational age 26-36.9, (31.8±2.4 weeks) • corrected age 6.2-70.7 months, (21.78±20.32 months) • MRI findings of diffuse PVL 36 age matched preterm controls

  5. Material & Methods II 1.5 Teslaunit, headcoil, 18- 24cm FOV • Sagittal SE T1(TR=500ms TE=20ms, 4mm thick, 0.4mmgap) • Axial TSE T2 (TR=3500ms TE=120ms, 5 mm thick, 0.5mmgap) • Coronal TSET2 (TR=3500ms TE=90, 2.5mm thick, 0mm gap) • 3D spoiled GRE T1 (TR=25ms, TE=4.6ms, 2mm gap)

  6. Data postprocessing I Segmentation Normalization SPM 5.0 + VBM 5.1 toolboxes 3D T1-WI forward MNI template

  7. Data postprocessing II IBASPM toolbox* Individual grey matter mask IBASPM atlas backward 116 GM areas volume computation Individual Atlas * Individual Brain Atlases using Statistical Parametric Mapping

  8. Statisticalanalysis Two tailed Student’s t-test P< 0.05 statistically significant

  9. Results Ι

  10. Results ΙI Diffuse PVL > preterm controls

  11. Discussion I GM volume: hippocampus amygdala olfactory gyrus frontal superior orbital middle temporal gyrus Preterm*: cognitive, behavioral, attention, language, visual- perceptual, learning and working memory deficits Dorsal limbic pathway * Dev Med Child Neurol. 2008 Sep;50(9):655-63 Lancet Neurol. 2009 Jan;8(1):110-24

  12. Discussion II Brain injury Reorganization – Plasticity • Axonal sprouting, synaptogenesis • Striatum, thalamus, pallidum crossroads of neuronal circuits • dPVL impairment of myelination, axonal degeneration axonal sprouting, synaptic prunning

  13. Conclusion • Diffuse PVL: • GM atrophy in areas associated with long term • neurodevelopmental outcome • Plasticity-reorganization

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