Detection of occult abnormalities in the deep gray matter nuclei of neonates with punctate white matter lesions by magnetic resonance spectroscopy

  • Qinli Sun
  • Miaomiao Wang
  • Xianjun Li
  • Chao Jin
  • Hui Zhang
  • Yuli Zhang
  • Fan Wu
  • Zhe Liu
  • Xiaoyu Wang
  • Congcong Liu
  • Xiaocheng Wei
  • Duan Xu
  • Jian YangEmail author
Paediatric Neuroradiology



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.


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.


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.


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.


Punctate white matter lesions Deep gray matter Neonate Magnetic resonance spectroscopy 



We would like to thank the guardians of the neonates for their written consent.

Funding information

This study was be funded by grants from the National Key Research and Development Program of China (2016YFC0100300), the National Natural Science Foundation of China (No. 81171317, 81471631, 81771810 and 51706178), the 2011 New Century Excellent Talent Support Plan of the Ministry of Education, China (NCET-11-0438), the China Postdoctoral Science Foundation (No. 2017M613145), the Shaanxi Provincial Natural Science Foundation for Youths of China (No. 2017JQ8005) and the Clinical Research Award of the First Affiliated Hospital of Xi’an Jiaotong University (No. XJTU1AF-CRF-2015-004).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this retrospective study, formal consent is not required.

Informed consent

Informed consent was obtained from the guardians of all individual participants included in this study.

Supplementary material

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Supplementary Table 1 (DOCX 25 kb)
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Supplementary Figure 1

(PNG 467 kb)

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High Resolution Image (TIF 1173 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and TechnologyXi’an Jiaotong UniversityXi’anPeople’s Republic of China
  2. 2.Department of Diagnostic RadiologyThe First Affiliated Hospital of Xi’an Jiaotong UniversityXi’anPeople’s Republic of China
  3. 3.Department of Radiology and Biomedical ImagingUniversity of San FranciscoSan FranciscoUSA

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