The clinical value of DTI-ALPS index in the evaluation of cerebral glymaphatic system function of neonates with hy-poxic ischemic encephalopathy recovery period

LI Qiancheng; WANG Wei; ZHANG Gongwei; LI Chenglong; DONG Lina; XU Chao; ZHANG Chao

doi:10.20258/j.cnki.1006-9011.2025.10.002

Abstract：Objective To analyze the clinical value of DTI-ALPS index in the evaluation of cerebral glymaphatic system func-tion of neonates with hypoxic ischemic encephalopathy(HIE)recovery periods.Methods A total of 31 neonates with HIE were selected as the observation group(HIE group).MRI routine sequence and DIT sequence scan were performed at about 4 weeks of age during the recovery,and the general motor quality assessment(GMs)was evaluated.Normal healthy infants at about 4 weeks of age during the study period were selected as the control group,relevant clinical data were collected.The ALPS index of the subjects was calculated through DTI technical parameters,and the differences in clinical characteristics and ALPS index among HIE group,control group,and infants with different degrees of HIE were analyzed.Spearman correlation analysis was used to evaluate the correlation between HIE degrees,GMs outcome,abnormal imaging findings and ALPS index.Results The ALPS index of the HIE group was significantly lower than that of the control group(P<0.01).The ALPS index of the mild HIE group was lower than that of the control group(P<0.05),the difference was not statistically significant(P>0.05).The ALPS index of mod-erate group and severe group was lower than that of mild group,but there was no significant difference between moderate group and severe group.The ALPS index of the abnormal GMs group was lower,and that of the imaging brain injury group was lower than that of the non-imaging brain injury group,and the difference was statistically significant(P<0.05 or<0.01).There was a negative correlation between the ALPS index and the severity of HIE,brain injury,abnormal brain structure,GMs ab-normal(r was-0.440,-0.440,-0.490,and-0.462,respectively),and all of them were statistically significant(P<0.05).Conclusion Neonates with HIE during recovery have GS dysfunction,which is correlated with the severity of HIE,abnormal GMs evaluation outcome,and imaging brain injury.