Boardman James P, Counsell Serena J, Rueckert Daniel, Kapellou Olga, Bhatia Kanwal K, Aljabar Paul, Hajnal Jo, Allsop Joanna M, Rutherford Mary A, Edwards A David
Imaging Sciences Department, MRC Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK.
Neuroimage. 2006 Aug 1;32(1):70-8. doi: 10.1016/j.neuroimage.2006.03.029. Epub 2006 May 3.
Preterm birth is a leading risk factor for neurodevelopmental and cognitive impairment in childhood and adolescence. The most common known cerebral abnormality among preterm infants at term equivalent age is a diffuse white matter abnormality seen on magnetic resonance (MR) images. It occurs with a similar prevalence to subsequent impairment, but its effect on developing neural systems is unknown. MR images were obtained at term equivalent age from 62 infants born at 24-33 completed weeks gestation and 12 term born controls. Tissue damage was quantified using diffusion-weighted imaging, and deformation-based morphometry was used to make a non-subjective survey of the whole brain to identify significant cerebral morphological alterations associated with preterm birth and with diffuse white matter injury. Preterm infants at term equivalent age had reduced thalamic and lentiform volumes without evidence of acute injury in these regions (t = 5.81, P < 0.05), and these alterations were more marked with increasing prematurity (t = 7.13, P < 0.05 for infants born at less than 28 weeks) and in infants with diffuse white matter injury (t = 6.43, P < 0.05). The identification of deep grey matter growth failure in association with diffuse white matter injury suggests that white matter injury is not an isolated phenomenon, but rather, it is associated with the maldevelopment of remote structures. This could be mediated by a disturbance to corticothalamic connectivity during a critical period in cerebral development. Deformation-based morphometry is a powerful tool for modelling the developing brain in health and disease, and can be used to test putative aetiological factors for injury.
早产是儿童期和青少年期神经发育及认知障碍的主要风险因素。足月相当年龄的早产儿中最常见的已知脑异常是磁共振（MR）图像上显示的弥漫性白质异常。其发生率与随后的损伤相似，但其对发育中的神经系统的影响尚不清楚。对62例孕24 - 33周出生的婴儿和12例足月出生的对照婴儿在足月相当年龄时进行了MR图像检查。使用扩散加权成像对组织损伤进行定量，并使用基于变形的形态测量法对全脑进行非主观测量，以确定与早产和弥漫性白质损伤相关的显著脑形态学改变。足月相当年龄的早产儿丘脑和豆状核体积减小，这些区域无急性损伤证据（t = 5.81，P < 0.05），且随着早产程度增加这些改变更明显（孕28周以下出生的婴儿t = 7.13，P < 0.05），在有弥漫性白质损伤的婴儿中也更明显（t = 6.43，P < 0.05）。与弥漫性白质损伤相关的深部灰质生长失败的发现表明，白质损伤不是一个孤立的现象，而是与远处结构的发育异常有关。这可能是由脑发育关键期皮质丘脑连接的紊乱介导的。基于变形的形态测量法是一种用于模拟健康和疾病状态下发育中大脑的强大工具，可用于测试假定的损伤病因因素。
