Objective:The aim of this diffusion tensor imaging (DTI) study was to explore the white matter (WM) variations due to punctate white matter lesions (PWML) in preterm and full term neonates using tract-based spatial statistics (TBSS) analysis. Materials and Methods:21 preterm and 25 full term patients with matched control neonates who underwent conventional MRI and DTI were enrolled. The differences of fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD) values between PWML group and paired control group were analyzed by using TBSS in preterm and full term neonates separately. Results:In both full term and preterm neonates with PWML, FA decreased signiifcantly in optic radiation (OR), posterior limb of internal capsule (PLIC), splenium of the corpus callosum (SCC) and body of the corpus callosum (BCC). Unlike single FA decrease in preterm neonates, RD and MD increased while FA decreased in full term neonates. Additional impaired WMs could be observed in full term neonates in genu of corpus callosum (GCC), corona radiate (CR), anterior and posterior central gyrus (ACS&PCS). Conclusions:The white matter (WM) variations due to neonatal PWML were not limited in the regions where these lesions located, and they were different between preterm and full term neonates in the distribution and extent.%目的利用纤维束空间统计分析(TBSS)法同时研究早产及足月局灶性脑白质损伤(PWML)患儿的MR 扩散张量成像(DTI)多参量变化特点。材料与方法分别纳入接受常规MRI及DTI扫描的21例早产和25例足月PWML患儿，并选择与之匹配的正常新生儿作为对照。所有新生儿DTI数据进行后处理及TBSS分析，比较各向异性分数(FA)、平均扩散率(MD)、平行扩散率(AD)、垂直扩散率(RD)在早产PWML和对照间、足月PWML和对照间的差异。结果在早产及足月PWML中，均发现FA值在内囊后肢、视辐射、胼胝体压部、胼胝体体部较对照组显著下降；足月PWML中白质改变的范围更广泛，还可见于胼胝体膝部、放射冠、中央前回和中央后回白质区内，且FA值降低的同时还伴随着M D及R D值的显著升高。结论 TBSS技术可发现新生儿PWML的脑白质损伤区域并不局限，早产和足月儿PWML存在不同程度和范围的脑白质损伤或/和发育延迟。
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