{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T07:10:34Z","timestamp":1791616234525,"version":"4.3.4"},"reference-count":24,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2003,7,1]]},"abstract":"<jats:p>Objective. The most common finding on magnetic resonance imaging (MRI) of the brain in preterm infants at term-equivalent age is diffuse excessive high signal intensity (DEHSI) in the white matter. It is unclear whether DEHSI represents a biological abnormality. This study used diffusion-weighted imaging (DWI) to compare apparent diffusion coefficient (ADC) values in DEHSI with infants with normal imaging and those with overt brain damage to determine whether DEHSI shows the diffusion characteristics of normal or abnormal tissue.<\/jats:p>\n               <jats:p>Methods. MRI, using conventional and diffusion-weighted imaging (DWI), was performed in 50 preterm infants at term-equivalent age using a 1.5 Tesla MR scanner. The infants were divided into 3 groups on the basis of their MRI results: 1) normal white matter, 2) DEHSI, or 3) overt white matter pathology. ADC values were measured in the frontal, central, and posterior white matter at the level of the centrum semiovale. ADC values in the 3 groups of preterm infants were compared using a 1-way analysis of variance with a Bonferroni test for multiple comparisons.<\/jats:p>\n               <jats:p>Results. ADC values were significantly higher in infants with DEHSI and infants with overt white matter pathology than in infants with normal white matter. There was no significant difference between ADC values in infants with DEHSI and those with overt white matter pathology.<\/jats:p>\n               <jats:p>Conclusions. This study provides objective evidence that DEHSI represents diffuse white matter abnormality.<\/jats:p>","DOI":"10.1542\/peds.112.1.1","type":"journal-article","created":{"date-parts":[[2004,8,14]],"date-time":"2004-08-14T00:43:47Z","timestamp":1092444227000},"page":"1-7","source":"Crossref","is-referenced-by-count":316,"title":["Diffusion-Weighted Imaging of the Brain in Preterm Infants With Focal and Diffuse White Matter Abnormality"],"prefix":"10.1542","volume":"112","author":[{"given":"Serena J.","family":"Counsell","sequence":"first","affiliation":[{"name":"Robert Steiner Magnetic Resonance Unit, Imaging Sciences Department, MRC Clinical Sciences Centre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna M.","family":"Allsop","sequence":"additional","affiliation":[{"name":"Robert Steiner Magnetic Resonance Unit, Imaging Sciences Department, MRC Clinical Sciences Centre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael C.","family":"Harrison","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine, Imperial College, Hammersmith Campus, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Larkman","sequence":"additional","affiliation":[{"name":"Robert Steiner Magnetic Resonance Unit, Imaging Sciences Department, MRC Clinical Sciences Centre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigel L.","family":"Kennea","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine, Imperial College, Hammersmith Campus, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Kapellou","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine, Imperial College, Hammersmith Campus, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances M.","family":"Cowan","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine, Imperial College, Hammersmith Campus, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph V.","family":"Hajnal","sequence":"additional","affiliation":[{"name":"Robert Steiner Magnetic Resonance Unit, Imaging Sciences Department, MRC Clinical Sciences Centre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. David","family":"Edwards","sequence":"additional","affiliation":[{"name":"Robert Steiner Magnetic Resonance Unit, Imaging Sciences Department, MRC Clinical Sciences Centre"},{"name":"Department of Paediatrics, Faculty of Medicine, Imperial College, Hammersmith Campus, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary A.","family":"Rutherford","sequence":"additional","affiliation":[{"name":"Robert Steiner Magnetic Resonance Unit, Imaging Sciences Department, MRC Clinical Sciences Centre"},{"name":"Department of Paediatrics, Faculty of Medicine, Imperial College, Hammersmith Campus, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2003,7,1]]},"reference":[{"key":"2021121003393279800_R1","doi-asserted-by":"crossref","unstructured":"Cooke RW. Trends in incidence of cranial ultrasound lesions and cerebral palsy in very low birthweight infants 1982\u201393. Arch Dis Child Fetal Neonatal Ed.1999;80:F115\u2013F117","DOI":"10.1136\/fn.80.2.F115"},{"key":"2021121003393279800_R2","doi-asserted-by":"crossref","unstructured":"Heuchan AM, Evans N, Henderson Smart DJ, Simpson JM. Perinatal risk factors for major intraventricular haemorrhage in the Australian and New Zealand Neonatal Network, 1995\u201397. Arch Dis Child Fetal Neonatal Ed.2002;86:F86\u2013F90","DOI":"10.1136\/fn.86.2.F86"},{"key":"2021121003393279800_R3","doi-asserted-by":"crossref","unstructured":"Maalouf EF, Duggan PJ, Rutherford MA, et al. Magnetic resonance imaging of the brain in a cohort of extremely preterm infants. J Pediatr.1999;135:351\u2013357","DOI":"10.1016\/S0022-3476(99)70133-2"},{"key":"2021121003393279800_R4","doi-asserted-by":"crossref","unstructured":"Le Bihan D, Breton E, Lallemand D, Grenier P, Cabanis E, Laval-Jeantet M. MR imaging of intravoxel incoherent motions: application to diffusion and perfusion in neurologic disorders. Radiology.1986;161:401\u2013407","DOI":"10.1148\/radiology.161.2.3763909"},{"key":"2021121003393279800_R5","doi-asserted-by":"crossref","unstructured":"Huppi PS, Maier SE, Peled S, et al. Microstructural development of human newborn cerebral white matter assessed in vivo by diffusion tensor magnetic resonance imaging. Pediatr Res.1998;44:584\u2013590","DOI":"10.1203\/00006450-199810000-00019"},{"key":"2021121003393279800_R6","doi-asserted-by":"crossref","unstructured":"Inder T, Huppi PS, Zientara GP, et al. Early detection of periventricular leukomalacia by diffusion-weighted magnetic resonance imaging techniques. J Pediatr.1999;134:631\u2013634","DOI":"10.1016\/S0022-3476(99)70251-9"},{"key":"2021121003393279800_R7","doi-asserted-by":"crossref","unstructured":"Miller SP, Vigneron DB, Henry RG, et al. Serial quantitative diffusion tensor MRI of the premature brain: development in newborns with and without injury. J Magn Reson Imaging.2002;16:621\u2013632","DOI":"10.1002\/jmri.10205"},{"key":"2021121003393279800_R8","doi-asserted-by":"crossref","unstructured":"Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics.1977;33:159\u2013174","DOI":"10.2307\/2529310"},{"key":"2021121003393279800_R9","doi-asserted-by":"crossref","unstructured":"Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet.1986;327:307\u2013310","DOI":"10.1016\/S0140-6736(86)90837-8"},{"key":"2021121003393279800_R10","doi-asserted-by":"crossref","unstructured":"Tanner SF, Ramenghi LA, Ridgway JP, et al. Quantitative comparison of intrabrain diffusion in adults and preterm and term neonates and infants. AJR Am J Roentgenol.2000;174:1643\u20131649","DOI":"10.2214\/ajr.174.6.1741643"},{"key":"2021121003393279800_R11","doi-asserted-by":"crossref","unstructured":"Toft PB, Leth H, Peitersen B, Lou HC, Thomsen C. The apparent diffusion coefficient of water in gray and white matter of the infant brain. J Comput Assist Tomogr.1996;20:1006\u20131011","DOI":"10.1097\/00004728-199611000-00029"},{"key":"2021121003393279800_R12","doi-asserted-by":"crossref","unstructured":"Sakuma H, Nomura Y, Takeda K, et al. Adult and neonatal human brain: diffusional anisotropy and myelination with diffusion-weighted MR imaging. Radiology.1991;180:229\u2013233","DOI":"10.1148\/radiology.180.1.2052700"},{"key":"2021121003393279800_R13","doi-asserted-by":"crossref","unstructured":"Huppi PS, Murphy B, Maier SE, et al. Microstructural brain development after perinatal cerebral white matter injury assessed by diffusion tensor magnetic resonance imaging. Pediatrics.2001;107:455\u2013460","DOI":"10.1542\/peds.107.3.455"},{"key":"2021121003393279800_R14","doi-asserted-by":"crossref","unstructured":"Neil JJ, Shiran SI, McKinstry RC, et al. Normal brain in human newborns: apparent diffusion coefficient and diffusion anisotropy measured by using diffusion tensor MR imaging. Radiology.1998;209:57\u201366","DOI":"10.1148\/radiology.209.1.9769812"},{"key":"2021121003393279800_R15","unstructured":"Counsell SJ, Allsop JM, Harrison MC, Edwards AD, Rutherford MA. Diffusion weighted imaging of the brain in preterm infants [abstract]. Childs Nerv Syst.2002;18:101"},{"key":"2021121003393279800_R16","doi-asserted-by":"crossref","unstructured":"Paneth N, Rudelli R, Monte W, et al. White matter necrosis in very low birth weight infants: neuropathologic and ultrasonographic findings in infants surviving six days or longer. J Pediatr.1990;116:975\u2013984","DOI":"10.1016\/S0022-3476(05)80664-X"},{"key":"2021121003393279800_R17","doi-asserted-by":"crossref","unstructured":"Volpe JJ, Herscovitch P, Perlman JM, Raichle ME. Positron emission tomography in the newborn: extensive impairment of regional cerebral blood flow with intraventricular hemorrhage and hemorrhagic intracerebral involvement. Pediatrics.1983;72:589\u2013601","DOI":"10.1542\/peds.72.5.589"},{"key":"2021121003393279800_R18","doi-asserted-by":"crossref","unstructured":"Altman DI, Powers WJ, Perlman JM, Herscovitch P, Volpe SL, Volpe JJ. Cerebral blood flow requirement for brain viability in newborn infants is lower than in adults. Ann Neurol.1988;24:218\u2013226","DOI":"10.1002\/ana.410240208"},{"key":"2021121003393279800_R19","doi-asserted-by":"crossref","unstructured":"Back SA, Gan X, Li Y, Rosenberg PA, Volpe JJ. Maturation-dependent vulnerability of oligodendrocytes to oxidative stress-induced death caused by glutathione depletion. J Neurosci.1998;18:6241\u20136253","DOI":"10.1523\/JNEUROSCI.18-16-06241.1998"},{"key":"2021121003393279800_R20","doi-asserted-by":"crossref","unstructured":"Duggan PJ, Maalouf EF, Watts TL, et al. Intrauterine T-cell activation and increased proinflammatory cytokine concentrations in preterm infants with cerebral lesions. Lancet.2001;358:1699\u20131700","DOI":"10.1016\/S0140-6736(01)06723-X"},{"key":"2021121003393279800_R21","doi-asserted-by":"crossref","unstructured":"Yoon BH, Jun JK, Romero RH, et al. Amniotic fluid inflammatory cytokines (interleukin-6, interleukin-1\u03b2, and tumor necrosis factor-\u03b1), neonatal brain white matter lesions, and cerebral palsy. Am J Obstet Gynecol.1997;177:19\u201326","DOI":"10.1016\/S0002-9378(97)70432-0"},{"key":"2021121003393279800_R22","doi-asserted-by":"crossref","unstructured":"Oka A, Belliveau MJ, Rosenberg PA, Volpe JJ. Vulnerability of oligodendroglia to glutamate: pharmacology, mechanisms, and prevention. J Neurosci.1993;13:1441\u20131453","DOI":"10.1523\/JNEUROSCI.13-04-01441.1993"},{"key":"2021121003393279800_R23","doi-asserted-by":"crossref","unstructured":"Yoshioka A, Bacskai B, Pleasure D. Pathophysiology of oligodendroglial excitotoxicity. J Neurosci Res.1996;46:427\u2013437","DOI":"10.1002\/(SICI)1097-4547(19961115)46:4<427::AID-JNR4>3.0.CO;2-I"},{"key":"2021121003393279800_R24","doi-asserted-by":"crossref","unstructured":"Murphy BP, Inder TE, Huppi PS, et al. Impaired cerebral cortical gray matter growth after treatment with dexamethasone for neonatal chronic lung disease. Pediatrics.2001;107:217\u2013221","DOI":"10.1542\/peds.107.2.217"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/112\/1\/1\/1002450\/pe0703000001.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/112\/1\/1\/1002450\/pe0703000001.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T10:39:48Z","timestamp":1639132788000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/112\/1\/1\/63388\/Diffusion-Weighted-Imaging-of-the-Brain-in-Preterm"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,7,1]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2003,7,1]]},"published-print":{"date-parts":[[2003,7,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.112.1.1","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003,7,1]]}}}