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极早早产儿的脑异常:一项基于瑞典人群的MRI研究

Brain abnormalities in extremely low gestational age infants: a Swedish population based MRI study.

作者信息

Horsch Sandra, Hallberg Boubou, Leifsdottir Kristin, Skiöld Béatrice, Nagy Zoltan, Mosskin Mikael, Blennow Mats, Adén Ulrika

机构信息

Department of Woman and Child Health, Karolinska Institutet Stockholm, Sweden.

出版信息

Acta Paediatr. 2007 Jul;96(7):979-84. doi: 10.1111/j.1651-2227.2007.00294.x. Epub 2007 May 24.

Abstract

AIMS

Brain abnormalities are common in preterm infants and can be reliably detected by magnetic resonance (MR) imaging at term equivalent age. The aim of the present study was to acquire population based data on brain abnormalities in extremely low gestational age (ELGA) infants from the Stockholm region and to correlate the MR findings to perinatal data, in order to identify risk factors.

METHODS

All infants with gestational age <27 weeks, born in the Stockholm region between January 2004 and August 2005, were scanned on a 1.5 T MR system at term equivalent age. Images were analysed using a previously established scoring system for grey and white matter abnormalities.

RESULTS

No or only mild white matter abnormalities were observed in 82% and moderate to severe white matter abnormalities in 18% of infants. The Clinical Risk Index for Babies (CRIB II) score, use of inotropes, the presence of high-grade intraventricular haemorrhages and posthaemorrhagic ventricular dilatation were associated with white matter abnormalities.

CONCLUSION

The incidence of moderate to severe white matter abnormalities in a population-based cohort of ELGA infants from the Stockholm region was 18%. To examine the clinical relevance of these promising results, neurodevelopmental follow up at 30 month corrected age, is ongoing.

摘要

目的

脑异常在早产儿中很常见,在足月等效年龄时可通过磁共振(MR)成像可靠检测。本研究的目的是获取来自斯德哥尔摩地区的极早早产儿(ELGA)脑异常的基于人群的数据,并将MR结果与围产期数据相关联,以确定风险因素。

方法

对2004年1月至2005年8月在斯德哥尔摩地区出生的所有孕周<27周的婴儿,在足月等效年龄时使用1.5T MR系统进行扫描。使用先前建立的灰质和白质异常评分系统对图像进行分析。

结果

82%的婴儿未观察到或仅观察到轻度白质异常,18%的婴儿观察到中度至重度白质异常。婴儿临床风险指数(CRIB II)评分、使用血管活性药物、存在高级别脑室内出血和出血后脑室扩张与白质异常相关。

结论

来自斯德哥尔摩地区的基于人群队列的ELGA婴儿中,中度至重度白质异常的发生率为18%。为了检验这些有前景结果的临床相关性,正在对校正年龄30个月时的神经发育进行随访。

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