Temporal alterations in brain water diffusivity in neonatal meningitis
Article first published online: 27 MAY 2009
© 2009 The Author(s)/Journal Compilation © 2009 Foundation Acta Pædiatrica
Volume 98, Issue 9, pages 1426–1432, September 2009
How to Cite
Malik, G. K., Yadav, A., Trivedi, R., Srivastava, A., Prasad, K. N. and Gupta, R. K. (2009), Temporal alterations in brain water diffusivity in neonatal meningitis. Acta Paediatrica, 98: 1426–1432. doi: 10.1111/j.1651-2227.2009.01353.x
- Issue published online: 27 JUL 2009
- Article first published online: 27 MAY 2009
- Received 16 January 2009; revised 30 March 2009; accepted 21 April 2009.
- Diffusion-weighted imaging;
- Hypoxic–ischaemic injury;
- Neonatal meningitis;
- Neurodevelopment assessment
Aim: To compare changes in apparent diffusion coefficient (ADC) in neonatal meningitis using serial diffusion-weighted imaging (DWI).
Method: Thirty neonates with meningitis and 12 age/sex-matched controls were studied using DWI. ADC was quantified by placing region of interest(s) on periventricular white matter during acute illness and again at 21 days. Three groups of patients were studied: those with normal findings on both conventional MRI and DWI, those with abnormal DWI only and those with abnormal conventional MRI as well as DWI. Neurodevelopment assessment was performed in controls and patients at 3 months using Indian adaptation of Bayley scales of infant development (BSID) kit.
Results: Patients with neonatal meningitis with normal imaging (n = 8) showed no significant difference in ADC compared to controls. Patients showing abnormality only on DWI (n = 10) and on both conventional magnetic resonance imaging (MRI) as well as DWI (n = 12) had significantly reduced ADC (p = 0.001) than controls at baseline study. Follow-up study showed no significant differences in ADC in controls compared to any patient group. Significantly reduced neurodevelopmental scores were observed in patient groups compared to controls.
Conclusion: We conclude that quantitative ADC may detect meningitis-induced hypoxia early in brain parenchyma, which may be associated with abnormal motor and mental development.