Department of Neonatology, Children's National Medical Center, Washington DC 20010, USA.
Am J Perinatol. 2010 Nov;27(10):803-18. doi: 10.1055/s-0030-1254550. Epub 2010 May 18.
Preterm birth is associated with variable degrees of brain injury and adverse neurodevelopmental outcomes. Neuroimaging has been investigated as a predictor of outcome in this population. Head ultrasound allows for rapid bedside evaluation of the neonatal brain for early intraventricular hemorrhage surveillance and later detection of periventricular leukomalacia. Computed tomography can provide excellent views for bones, hemorrhage, extra-axial space, and the ventricles but is rarely used for prognostic purposes. Magnetic resonance imaging allows for high-resolution images of brain structures, differentiation of white and gray matter, visualization of the brain stem and posterior fossa, and getting additional physiological information with specialized sequences. Though controversial, the use of magnetic resonance imaging, at term equivalent, as a predictor of later outcome in preterm infants has been increasing and has been advocated by some as a standard practice. In this article, we review and contrast the use of these various imaging modalities in predicting neurodevelopmental outcome of premature infants.
早产与不同程度的脑损伤和不良神经发育结局相关。神经影像学已被研究作为该人群预后的预测指标。头颅超声可在床边快速评估新生儿的大脑,用于早期监测室管膜下出血,并随后发现脑室周围白质软化。计算机断层扫描可提供骨骼、出血、颅外间隙和脑室的极佳图像,但很少用于预测目的。磁共振成像可提供脑结构的高分辨率图像,区分白质和灰质,显示脑干和后颅窝,并通过特殊序列获得额外的生理信息。尽管存在争议,但在足月时使用磁共振成像作为预测早产儿后期结局的指标的做法越来越多,一些人主张将其作为标准做法。本文综述并比较了这些不同的影像学方法在预测早产儿神经发育结局中的应用。