Peterson Bradley S, Anderson Adam W, Ehrenkranz Richard, Staib Lawrence H, Tageldin Magdi, Colson Eve, Gore John C, Duncan Charles C, Makuch Robert, Ment Laura R
Columbia College of Physicians and Surgeons and the New York State Psychiatric Institute, New York, New York 10032, USA.
Pediatrics. 2003 May;111(5 Pt 1):939-48. doi: 10.1542/peds.111.5.939.
To compare regional brain volumes measured in term and preterm infants, and to correlate regional volumes with measures of neurodevelopmental outcome.
High-contrast, high-resolution magnetic resonance imaging scans were acquired in 10 preterm and 14 term infants who were scanned near term. The cerebrum was segmented into cortical gray matter, white matter, cerebral ventricles, subcortical gray matter, cerebellum, and brainstem. The cortical gray matter, white matter, and ventricles were further divided into specific anatomic subregions, and the volumes were compared across groups. Measures of cognitive and motor development were acquired between 18 and 20 months of corrected age. Correlations of regional brain volumes with developmental outcome were assessed in the preterm group.
Volumes in preterm infants were reduced in parieto-occipital gray matter and increased in the midbody, occipital horn, and temporal horns of the lateral ventricles. Gray matter volumes were also less prominently reduced in the sensorimotor and inferior occipital cortices. Normal lateralization of white matter volumes were altered in the parieto-occipital region in the preterm infants, who had significantly larger left-sided and smaller right-sided structures. White matter volumes in the sensorimotor and midtemporal regions correlated strongly with measures of neurodevelopmental outcome.
These findings of reduced volumes in sensorimotor and parieto-occipital regions in preterm infants, and the prospective correlations of regional volumes with cognitive outcome, confirm and extend findings previously reported in a cross-sectional study of 8-year-old prematurely born children. The data suggest that regional brain volumes near term are a promising marker for predicting disturbances of cognitive outcome in preterm infants. Further prospective, longitudinal studies of neonatal brain volumes and developmental indices into later childhood are required to confirm the utility of regional brain volumes as predictors of longer term outcome.
比较足月儿和早产儿的脑区体积，并将脑区体积与神经发育结局指标进行关联分析。
对10例早产儿和14例足月儿在接近足月时进行了高对比度、高分辨率磁共振成像扫描。将大脑分为皮质灰质、白质、脑室、皮质下灰质、小脑和脑干。皮质灰质、白质和脑室进一步分为特定的解剖亚区域，并对各组间的体积进行比较。在矫正年龄18至20个月时获取认知和运动发育指标。评估早产儿脑区体积与发育结局的相关性。
早产儿顶枕部灰质体积减小，侧脑室体部、枕角和颞角体积增大。感觉运动皮质和枕叶下部皮质的灰质体积减少也不那么明显。早产儿顶枕区白质体积的正常偏侧化改变，左侧结构明显较大，右侧结构较小。感觉运动区和颞中区的白质体积与神经发育结局指标密切相关。
早产儿感觉运动区和顶枕区体积减小的这些发现，以及脑区体积与认知结局的前瞻性相关性，证实并扩展了先前在一项对8岁早产儿的横断面研究中报告的结果。数据表明，接近足月时的脑区体积是预测早产儿认知结局障碍的一个有前景的标志物。需要进一步对新生儿脑体积和儿童后期发育指标进行前瞻性纵向研究，以确认脑区体积作为长期结局预测指标的效用。
