Cornette L G, Tanner S F, Ramenghi L A, Miall L S, Childs A M, Arthur R J, Martinez D, Levene M I
Department of Paediatrics and Child Health, Leeds General Infirmary, Leeds, UK.
Arch Dis Child Fetal Neonatal Ed. 2002 May;86(3):F171-7. doi: 10.1136/fn.86.3.f171.
To describe the magnetic resonance imaging (MRI) characteristics of punctate brain lesions in neonates (number, appearance, distribution, and association with other brain abnormalities) and to relate them to neurodevelopmental outcome.
A retrospective analysis was performed of 110 MRI brain scans from 92 infants admitted in 1998 to the neonatal intensive care unit. Results of routine neurodevelopmental follow up (1998-2001) in those infants with punctate brain lesions were analysed.
Punctate lesions were observed in 15/50 preterm and 2/42 term infants. In the preterm group, the number of lesions was < 3 in 20%, 3-10 in 27%, and > 10 in 53%. In 14/15 the lesions were linearly organised and located in the centrum semiovale. Other brain abnormalities were absent or minor--that is, "isolated" punctate lesions--in 8/15 and major in 7/15. In the term group, punctate lesions were organised in clusters and no other brain abnormalities were observed. Isolated punctate lesions were observed in 10/17 infants, and a normal neurodevelopmental outcome was seen in 9/10 (mean follow up 29.5 months). One infant showed a slight delay in language development. In the infants with associated brain lesions (7/17, mean follow up 27.5 months), outcome was normal in only two subjects.
Punctate lesions are predominantly seen in preterm infants, are usually linearly organised, and border the lateral ventricles. Isolated punctate lesions may imply a good prognosis, because most of these subjects have a normal neurodevelopmental outcome so far.
描述新生儿脑内点状病变的磁共振成像（MRI）特征（数量、表现、分布以及与其他脑异常的关联），并将其与神经发育结局相关联。
对1998年入住新生儿重症监护病房的92例婴儿的110次脑部MRI扫描进行回顾性分析。分析了那些有脑内点状病变婴儿的常规神经发育随访结果（1998 - 2001年）。
在15/50例早产儿和2/42例足月儿中观察到点状病变。在早产儿组中，病变数量<3个的占20%，3 - 10个的占27%，>10个的占53%。在14/15例中，病变呈线性排列，位于半卵圆中心。其他脑异常不存在或较轻微——即“孤立”点状病变——在8/15例中，严重的在7/15例中。在足月儿组中，点状病变成簇分布，未观察到其他脑异常。在10/17例婴儿中观察到孤立点状病变，9/10例（平均随访29.5个月）神经发育结局正常。1例婴儿语言发育略有延迟。在有相关脑病变婴儿中（7/17例，平均随访27.5个月），仅2例结局正常。
点状病变主要见于早产儿，通常呈线性排列，且靠近侧脑室。孤立点状病变可能预示良好预后，因为到目前为止这些婴儿大多数神经发育结局正常。
