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早产后的磁共振成像与发育结局:当前证据综述

Magnetic resonance imaging and developmental outcome following preterm birth: review of current evidence.

作者信息

Hart Anthony R, Whitby Elspeth W, Griffiths Paul D, Smith Michael F

机构信息

Neonatal Intensive Care Unit, Jessop Wing, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK.

出版信息

Dev Med Child Neurol. 2008 Sep;50(9):655-63. doi: 10.1111/j.1469-8749.2008.03050.x.

Abstract

Preterm birth is associated with an increased risk of developmental difficulties. Magnetic resonance imaging (MRI) is increasingly being used to identify damage to the brain following preterm birth. It is hoped this information will aid prognostication and identify neonates who would benefit from early therapeutic intervention. Cystic periventricular white matter damage has traditionally been associated with abnormal motor developmental and cerebral palsy, but its presence on MRI does not preclude normal cognitive development. This has led to increasing interest in the identification of diffuse periventricular white matter damage with conventional and sophisticated MRI. However, the correlation between these appearances and developmental outcome remains unclear. Measurements of the size, volumes, and growth rates of many regions of the brain, such as the corpus callosum, ventricular system, cortex, deep grey matter, and cerebellum, are all also altered following preterm birth, but there is insufficient evidence to use this data in the clinical setting. This article is a review of the current evidence on MRI and developmental outcome, suggesting possible indications for the use of MRI following preterm birth.

摘要

早产与发育困难风险增加相关。磁共振成像(MRI)越来越多地用于识别早产后脑损伤情况。人们希望这些信息将有助于预后评估,并识别出能从早期治疗干预中获益的新生儿。传统上,脑室周围白质囊性损伤与运动发育异常和脑瘫有关,但MRI上出现这种损伤并不排除认知发育正常。这使得人们越来越关注通过传统和先进的MRI识别弥漫性脑室周围白质损伤。然而,这些表现与发育结局之间的相关性仍不明确。许多脑区,如胼胝体、脑室系统、皮质、深部灰质和小脑的大小、体积及生长速率测量值在早产之后也都会发生改变,但在临床环境中使用这些数据的证据不足。本文综述了目前关于MRI与发育结局的证据,提出了早产之后使用MRI的可能指征。

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