Clinical Trials Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Sep 28, 2020; 12(9): 204-212
Published online Sep 28, 2020. doi: 10.4329/wjr.v12.i9.204
Application of voxel-based morphometric method to detect brain changes in children with non-cyanotic congenital heart disease
Xuan Jia, Xiao-Hui Ma, Jia-Wei Liang
Xuan Jia, Xiao-Hui Ma, Jia-Wei Liang, Department of Radiology, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
Author contributions: Jia X and Ma XH designed the study; Jia X wrote the first draft of the manuscript; Liang JW collected the data; Zhou HC performed the literature search and analysis; Mi YH conducted the statistical analysis; all authors participated in and approved the final manuscript.
Institutional review board statement: The study was approved by the Institutional Review Board of the Children's Hospital, Zhejiang University School of Medicine.
Clinical trial registration statement: The study protocol was approved by the ethics committee of the Children's Hospital of Zhejiang University School of Medicine, No. 2019-IRB-047.
Informed consent statement: The parents/legal guardians of all children provided written informed consent before their participation in this study.
Conflict-of-interest statement: The authors report no conflicts of interest. The authors are solely responsible for the content and writing of this article.
Data sharing statement: All authors agree to share the data in this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xuan Jia, MD, Attending Doctor, Department of Radiology, The Children's Hospital, Zhejiang University School of Medicine, No. 3333 Binsheng Road, Binjiang District, Hangzhou 310000, Zhejiang Province, China. 6202059@zju.edu.cn
Received: April 19, 2020
Peer-review started: April 19, 2020
First decision: June 5, 2020
Revised: June 7, 2020
Accepted: August 25, 2020
Article in press: August 25, 2020
Published online: September 28, 2020
Abstract
BACKGROUND

Congenital heart disease (CHD) is a cardiovascular malformation caused by abnormal heart and/or vascular development in the fetus. In children with CHD, abnormalities in the development and function of the nervous system are common. At present, there is a lack of research on the preoperative neurological development and injury in young children with non-cyanotic CHD.

AIM

To determine the changes in white matter, gray matter, and cerebrospinal fluid (CSF) by magnetic resonance imaging (MRI) in children with non-cyanotic CHD as compared with healthy controls.

METHODS

Children diagnosed with non-cyanotic CHD on ultrasonography (n = 54) and healthy control subjects (n = 35) were included in the study. All the subjects were aged 1–3 years. Brain MRI was performed prior to surgery for CHD. The SPM v12 software was used to calculate the volumes of the gray matter, white matter, CSF, and the whole brain (sum of the gray matter, white matter, and CSF volumes). Volume differences between the two groups were analyzed. Voxel-based morphometry was used to compare specific brain regions with statistically significant atrophy.

RESULTS

Compared with the control group, the study group had significantly reduced whole-brain white matter volume (P < 0.05), but similar whole-brain gray matter, CSF, and whole-brain volumes (P > 0.05). As compared with the healthy controls, children with non-cyanotic CHD had mild underdevelopment in the white matter of the anterior central gyrus, the posterior central gyrus, and the pulvinar.

CONCLUSION

Children with non-cyanotic CHD show decreased white matter volume before surgery, and this volume reduction is mainly concentrated in the somatosensory and somatic motor nerve regions.

Keywords: Voxel-based morphometry, Non-cyanotic congenital heart disease, Young children, Magnetic resonance imaging

Core Tip: As research on the preoperative development and injury of the nervous system in patients with non-cyanotic congenital heart disease (CHD) is currently lacking, the present study aimed to determine the changes in whole-brain white matter, whole-brain gray matter, and the cerebrospinal fluid in children with CHD relative to healthy controls, by using a voxel-based morphometry technique. We hope that the results will help facilitate early clinical intervention in these children, and reduce or prevent the occurrence and progression of nervous system damage.