Valkama A M, Pääkkö E L, Vainionpää L K, Lanning F P, Ilkko E A, Koivisto M E
Department of Paediatrics, University of Oulu, Finland.
Acta Paediatr. 2000 Mar;89(3):348-55.
In order to evaluate the value of neonatal brain magnetic resonance imaging (MRI) for predicting neuromotor outcome in very low birthweight (VLBW) preterm infants, 51 such infants with gestational age <34 wk underwent brain MRI at term age. Myelination, parenchymal lesions (haemorrhage, leukomalacia, infarction, reduction of white matter), parenchymal lesions without subependymal haemorrhage, ventricular/brain ratios and widths of the extracerebral spaces were assessed. The MRI findings were compared with cranial ultrasound (US) performed at term. Infants' neuromotor development was followed up until 18 mo corrected age. Parenchymal lesions seen in MRI at term predicted cerebral palsy (CP) with 100% sensitivity and 79% specificity, the corresponding figures for US being 67% and 85%, respectively. Parenchymal lesions in MRI, excluding subependymal haemorrhages, predicted CP with a sensitivity of 82% and a specificity of 97%, the corresponding figures for US being 58% and 100%, respectively. Delayed myelination, ventricular/brain ratios and widths of the extracerebral spaces failed to predict CP. Term age is a good time for neuroradiological examinations in prematurely born high-risk infants. Parenchymal lesions seen in MRI are reliable predictors for CP.
为了评估新生儿脑磁共振成像（MRI）对预测极低出生体重（VLBW）早产儿神经运动结局的价值，51例胎龄<34周的此类早产儿在足月时接受了脑部MRI检查。评估了髓鞘形成、实质病变（出血、脑白质软化、梗死、白质减少）、无室管膜下出血的实质病变、脑室/脑比率和脑外间隙宽度。将MRI检查结果与足月时进行的头颅超声（US）检查结果进行比较。对婴儿的神经运动发育进行随访至矫正年龄18个月。足月时MRI所见的实质病变预测脑瘫（CP）的敏感性为100%，特异性为79%，US的相应数字分别为67%和85%。MRI中的实质病变（不包括室管膜下出血）预测CP的敏感性为82%，特异性为97%，US的相应数字分别为58%和100%。髓鞘形成延迟、脑室/脑比率和脑外间隙宽度未能预测CP。足月时是对早产高危婴儿进行神经放射学检查的良好时机。MRI所见的实质病变是CP的可靠预测指标。
