The Role of Diffusion Tensor Magnetic Resonance Imaging in Understanding Neurological and Ocular Outcomes in Preterm Infants with Periventricular Leukomalacia
Makaleler > Tam Makale · 2025
Yazarlar: Yıldız EKEMEN KELEŞ, Elif DEMİRKILINÇ, Filiz AFRASHİ, Mehmet Cem ÇALLI, Mehmet YALAZ, Sema TANRIVERDİ, Sanem KESKİN YILMAZ, GÜL AKTAN, SARENUR GÖKBEN
Forbes Journal of Medicine, Uluslararası, 2025, cilt 6, ss 273-282
DOI: 10.4274/forbes.galenos.2025.94940
Özet
Objective: This study aimed to compare neurological and ophthalmological findings with diffusion tensor magnetic resonance imaging (DTMRI) results in patients with periventricular leukomalacia (PVL).Methods: This prospective study included 24 premature infants with PVL diagnosed by cranial ultrasonography (USG) or magnetic resonance imaging (MRI).Neurological and comprehensive ophthalmological evaluations were conducted at 3, 6, and 12 months of corrected age.MRI was performed on a 3-Tesla scanner, and DTMRI data were analyzed for fractional anisotropy (FA) and other diffusion parameters.Statistical analyses were performed using SPSS software, with p<0.05 considered significant.Results: Our study included 11 preterm patients with PVL, of whom 72.7% developed cerebral palsy (CP) by 6 months' corrected age.Cranial USG detected PVL in 63.3% of patients, whereas MRI identified PVL of varying severity: mild (54.5%), moderate (18.2%), and severe (27.3%).Neurological examinations revealed increased muscle tone and brisk deep tendon reflexes (DTRs), findings consistent with early indicators of CP.Ophthalmologic assessments indicated normal light fixation and tracking in most patients, though visual evoked potentials (VEPs) revealed abnormalities in 63.6% of patients.In the DTMRI results, right optic tract, FA values were found to be significantly lower in the patient group compared to the control group (p=0.010).Conclusion: Early neurological signs, such as increased muscle tone and brisk DTRs, are predictive of subsequent CP.Despite improvements in visual tracking, VEP abnormalities highlight the need for comprehensive neuro-ophthalmological evaluations in preterm infants.DTMRI provides valuable insights into white matter microstructure and may help predict neurological and ophthalmological outcomes in infants with PVL.