PURPOSE Punctate white matter lesions (PWML) are common in preterm neonates and have also been reported in the full term. While most studies focus on white matter abnormalities, gray matter (GM) alterations are generally ignored due to the lack of abnormalities on conventional MRI. This study aims to investigate whether magnetic resonance spectroscopy is a sensitive and practical method to detect occult alterations of deep GM nuclei in these neonates. METHODS Neonates with PWML and controls with no MRI abnormalities were retrospectively studied. Apparent diffusion coefficient values and metabolic ratios (Cho/Cr, NAA/Cho, and NAA/Cr) in the lenticular nucleus and the thalamus were compared between the PWML and control groups. RESULTS Forty-two neonates with PWML (grades I, II, and III contained 14, 21, and 7 subjects, respectively) and 50 controls were enrolled. Apparent diffusion coefficient values in the lenticular nucleus and the thalamus were not significantly different between the PWML and the control groups. The NAA/Cho ratio was significantly lower in the PWML group than in the control group in both regions, whereas a lower NAA/Cr ratio was only observed in the thalamus. Significantly lower ratios of NAA/Cho in both regions and NAA/Cr in the thalamus were detected in the grade II and III subgroup, whereas the thalamic NAA/Cho ratio was decreased in the grade I group compared with controls. CONCLUSIONS Magnetic resonance spectroscopy is a sensitive method for detecting the occult deep GM abnormalities for the study cohort of neonates with PWML when compared with subjects without PWML.

中文翻译：

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核磁共振波谱法检测点状白质病变新生儿的深部灰质核中的隐匿异常。

目的点状白质病灶（PWML）在早产新生儿中很常见，并且在整个足月中也有报道。尽管大多数研究关注白质异常，但由于常规MRI缺乏异常，灰质（GM）改变通常被忽略。这项研究旨在调查磁共振波谱法是否是检测这些新生儿深部GM核隐匿性改变的灵敏实用方法。方法回顾性分析无PWM异常的新生儿和无MRI异常的对照组。比较了PWML组和对照组的表观扩散系数值和新陈代谢率（Cho / Cr，NAA / Cho和NAA / Cr）在双凸透镜核和丘脑中的分布。结果42例PWML新生儿（I，II和III级包含14、21和7名受试者，分别）和50个对照。在PWML组和对照组之间，在透镜状核和丘脑中的表观扩散系数值没有显着差异。在两个区域中，PWML组的NAA / Cho比均显着低于对照组，而仅在丘脑中观察到较低的NAA / Cr比。在II级和III级亚组中，两个区域的NAA / Cho比和丘脑中的NAA / Cr比均显着降低，而I级组的丘脑NAA / Cho比与对照相比降低。结论磁共振波谱法是检测患有PWML的新生儿与没有PWML的受试者相比隐匿性深部GM异常的灵敏方法。在PWML组和对照组之间，在透镜状核和丘脑中的表观扩散系数值没有显着差异。在两个区域中，PWML组的NAA / Cho比均显着低于对照组，而仅在丘脑中观察到较低的NAA / Cr比。在II级和III级亚组中，两个区域的NAA / Cho比和丘脑中的NAA / Cr比均显着降低，而I级组的丘脑NAA / Cho比与对照相比降低。结论磁共振波谱法是检测患有PWML的新生儿与没有PWML的受试者相比隐匿性深部GM异常的灵敏方法。在PWML组和对照组之间，在透镜状核和丘脑中的表观扩散系数值没有显着差异。在两个区域中，PWML组的NAA / Cho比均显着低于对照组，而仅在丘脑中观察到较低的NAA / Cr比。在II级和III级亚组中，两个区域的NAA / Cho比和丘脑中的NAA / Cr比均显着降低，而I级组的丘脑NAA / Cho比与对照相比降低。结论磁共振波谱法是检测患有PWML的新生儿与没有PWML的受试者相比隐匿性深部GM异常的灵敏方法。在两个区域中，PWML组的NAA / Cho比均显着低于对照组，而仅在丘脑中观察到较低的NAA / Cr比。在II级和III级亚组中，两个区域的NAA / Cho比和丘脑中的NAA / Cr比均显着降低，而I级组的丘脑NAA / Cho比与对照相比降低。结论磁共振波谱法是检测患有PWML的新生儿与没有PWML的受试者相比隐匿性深部GM异常的灵敏方法。在两个区域中，PWML组的NAA / Cho比均显着低于对照组，而仅在丘脑中观察到较低的NAA / Cr比。在II级和III级亚组中，两个区域的NAA / Cho比和丘脑中的NAA / Cr比均显着降低，而I级组的丘脑NAA / Cho比与对照相比降低。结论磁共振波谱法是检测患有PWML的新生儿与没有PWML的受试者相比隐匿性深部GM异常的灵敏方法。在II级和III级亚组中，两个区域的NAA / Cho比和丘脑中的NAA / Cr比均显着降低，而I级组的丘脑NAA / Cho比与对照相比降低。结论磁共振波谱法是检测患有PWML的新生儿与没有PWML的受试者相比隐匿性深部GM异常的灵敏方法。在II级和III级亚组中，两个区域的NAA / Cho比和丘脑中的NAA / Cr比均显着降低，而I级组的丘脑NAA / Cho比与对照相比降低。结论磁共振波谱法是检测患有PWML的新生儿与没有PWML的受试者相比隐匿性深部GM异常的灵敏方法。