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KMID : 0391520160240030149
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Journal of the Korean Child Neurology Society
2016 Volume.24 No. 3 p.149 ~ p.156
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Association between Rotavirus Infection and White Matter Injury on Diffusion-Weighted Imaging in Term Neonates
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Kim Young-Bae
Lee Weon-Kyung
Jeon Ga-Won
Sin Jong-Beom
Lee Bo-Lyun
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Abstract
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Purpose: The purpose of this study was to investigate the clinical features and neurodevelopmental outcomes of white matter injury (WMI) using magnetic resonance diffusion-weighted imaging (DWI) in term neonates, associated with rotavirus infection.
Methods: A retrospective study was conducted on 40 neonates with WMI admitted between January 2010 and December 2015. Eighteen patients (group I) had symmetrical periventricular WMI without cerebral cortical lesions on DWI. The other 22 patients (group II) had cortical lesions as well as WMI and were diagnosed with neonatal encephalopathy by specific causes.
Results: Sixteen patients (88.9%) in group I tested positive for stool rotavirus antigen, whereas only 1 of 22 patients (4.5%) in group II tested positive. All patients in group I and eighteen patients (81.8%) in group II had seizures. Average seizure onset occurred at 4.7±1.0 days and 2.6±3.7 days in group I and II, respectively. Hypocalcemia was identified in 7 out of 18 patients in group I, but none in group II. Ten out of 12 patients (83.3%) in group I had normal developmental outcomes, but only 9 out of 16 patients (56.2%) in group II showed normal development between 6 and 26 months of age.
Conclusion: Term neonates with WMI without cortical lesions on DWI had a high positive rate of rotavirus infection, but showed generally good neurodevelopmental outcomes. In this study, hypocalcemia was identified in some patients with WMI associated with rotavirus infection, but the pathomechanism for this was unclear. Therefore, further research will be necessary.
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KEYWORD
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Newborn, Encephalopathy, Diffusion magnetic resonance imaging, Rotavirus, Seizures
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