Abernethy Laurence J, Klafkowski Gillian, Foulder-Hughes Lynda, Cooke Richard W I
Department of Radiology, Royal Liverpool Children's Hospital, Liverpool L12 2AP, UK.
Pediatr Res. 2003 Dec;54(6):868-74. doi: 10.1203/01.PDR.0000091285.84577.4E. Epub 2003 Aug 20.
The objective of this study was to determine whether intelligence and minor motor impairments in children who are born preterm without major disability are associated with cerebral white matter (CWM) and hippocampal abnormalities on magnetic resonance imaging (MRI). A total of 103 preterm children were studied at age 7 y with detailed magnetic resonance brain scans, including a T2-mapping sequence from which T2 relaxation times of the CWM and hippocampal formations were calculated. All of the children had no major motor disability, attended normal school, and had undergone assessment of IQ and a test for minor motor impairment (MMI). Twenty children had visible lesions on MRI, which were associated with lower IQ and more frequent MMI. Mean (SD) IQ was 90 (14.1). Twenty-five children were shown to have MMI (Movement ABC at below the fifth centile). This group was shown to have significantly longer T2 relaxation times for CWM (mean difference 2.1 ms right, 3.1 ms left) but not the hippocampus than the children without MMI. These differences persisted when only children without visible lesions on scans were considered (mean difference 1.5 ms bilaterally). There was no significant correlation between IQ and T2 relaxation times. Children who are born preterm without subsequent major neurodisability may, in addition to visible lesions on MRI scans, have a diffuse abnormality of CWM, manifest as an increase in T2 relaxation time. This abnormality shows a close correlation with minor motor impairment but not with full-scale IQ.
本研究的目的是确定出生时无重大残疾的早产儿童的智力和轻度运动障碍是否与磁共振成像(MRI)上的脑白质(CWM)和海马异常有关。对103名7岁的早产儿童进行了详细的脑部磁共振扫描研究,包括一个T2映射序列,据此计算CWM和海马结构的T2弛豫时间。所有儿童均无重大运动残疾,就读于普通学校,并接受了智商评估和轻度运动障碍(MMI)测试。20名儿童在MRI上有可见病变,这与较低的智商和更频繁的MMI有关。平均(标准差)智商为90(14.1)。25名儿童被证明有MMI(运动ABC低于第五百分位数)。与没有MMI的儿童相比,这组儿童的CWM的T2弛豫时间明显更长(右侧平均差异2.1毫秒,左侧3.1毫秒),但海马的T2弛豫时间没有明显差异。当只考虑扫描时没有可见病变的儿童时,这些差异仍然存在(双侧平均差异1.5毫秒)。智商与T2弛豫时间之间没有显著相关性。出生时早产且随后无重大神经残疾的儿童,除了MRI扫描上有可见病变外,可能还存在CWM的弥漫性异常,表现为T2弛豫时间增加。这种异常与轻度运动障碍密切相关,但与全量表智商无关。