Abnormal White Matter and Gray Matter Maturation in Premature Neonates with Periventricular Hemorrhagic Infarction: A Diffusion Tensor Imaging Study

Periventricular hemorrhagic infarct (PVHI) is among the most devastating injuries suffered by prematurely born infants. In PVHI (formerly called Grade 4 intraventricular hemorrhage), an intraventricular vein that drains smaller veins from the surrounding white matter is occluded, resulting in venous infarction with hemorrhage [1]. DTI has become a useful imaging technique to identify maturational trends reflecting microstructural changes in white matter (WM) & gray matter (GM) of the developing brain [2-4] and has been shown to detect microstructural injury, even in normal appearing neonatal WM [5]. However, there have been no reports of abnormal microstructural maturation in GM with DTI. Furthermore, there have been no prior DTI studies of PVHI. In this study, we hypothesize that, in prematurely born neonates with PVHI, DTI would be able to detect abnormal microstructural development in WM and GM that appear normal on conventional T1weighted and T2-weighted MR imaging. Materials and methods