Miller Steven P, Ferriero Donna M, Leonard Carol, Piecuch Robert, Glidden David V, Partridge J Colin, Perez Marta, Mukherjee Pratik, Vigneron Daniel B, Barkovich A James
Department of Neurology, University of California San Francisco, San Francisco, CA 94143, USA.
J Pediatr. 2005 Nov;147(5):609-16. doi: 10.1016/j.jpeds.2005.06.033.
To determine the neurodevelopmental outcome of prematurely born newborns with magnetic resonance imaging (MRI) abnormalities.
A total of 89 prematurely born newborns (median age 28 weeks postgestation) were studied with MRI when stable for transport to MRI (median age, 32 weeks postgestation); 50 newborns were studied again near term age (median age, 37 weeks). Neurodevelopmental outcome was determined at 18 months adjusted age (median) using the Mental Development Index (Bayley Scales Infant Development II) and a standardized neurologic exam.
Of 86 neonatal survivors, outcome was normal in 51 (59%), borderline in 22 (26%), and abnormal in 13 (15%). Moderate/severe MRI abnormalities were common on the first (37%) and second (32%) scans. Abnormal outcome was associated with increasing severity of white matter injury, ventriculomegaly, and intraventricular hemorrhage on MRI, as well as moderate/severe abnormalities on the first (relative risk [RR] = 5.6; P = .002) and second MRI studies (RR = 5.3; P = .03). Neuromotor abnormalities on neurologic examination near term age (RR = 6.5; P = .04) and postnatal infection (RR = 4.0; P = .01) also increased the risk for abnormal neurodevelopmental outcome.
In premature newborns, brain abnormalities are common on MRI early in life and are associated with adverse neurodevelopmental outcome.
确定患有磁共振成像（MRI）异常的早产新生儿的神经发育结局。
共有89名早产新生儿（孕龄中位数为28周）在病情稳定可转运至MRI检查时接受了MRI检查（孕龄中位数为32周）；其中50名新生儿在接近足月时（孕龄中位数为37周）再次接受检查。使用心理发育指数（贝利婴儿发育量表第二版）和标准化神经学检查，在矫正年龄18个月（中位数）时确定神经发育结局。
86名新生儿幸存者中，51名（59%）结局正常，22名（26%）临界正常，13名（15%）异常。在首次（37%）和第二次（32%）扫描中，中度/重度MRI异常很常见。异常结局与MRI上白质损伤、脑室扩大和脑室内出血的严重程度增加相关，以及与首次（相对风险[RR]=5.6；P=0.002）和第二次MRI研究中的中度/重度异常相关（RR=5.3；P=0.03）。足月时神经学检查发现的神经运动异常（RR=6.5；P=0.04）和产后感染（RR=4.0；P=0.01）也增加了神经发育异常结局的风险。
在早产新生儿中，生命早期MRI上脑异常很常见，且与不良神经发育结局相关。
