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不同胎龄新生儿正电子发射断层显像变化与新生儿缺氧缺血性脑病。

Changes of positron emission tomography in newborn infants at different gestational ages, and neonatal hypoxic-ischemic encephalopathy.

机构信息

Department of Pediatrics, Daping Hospital, Third Military Medical University, Chongqing, China.

出版信息

Pediatr Neurol. 2012 Feb;46(2):116-23. doi: 10.1016/j.pediatrneurol.2011.11.005.

Abstract

Cerebral glucose metabolism was measured by (18)F-fluorodeoxyglucose position emission tomography in infants at different gestational ages and with neonatal hypoxic-ischemic encephalopathy. Thirty-six preterm and term infants at different gestational ages without brain injury were divided into four subgroups: ≤32 weeks (n = 4), 33-34 weeks (n = 5), 35-36 weeks (n = 12), and ≥37 weeks (n = 15). Twenty-four newborn infants with hypoxic-ischemic encephalopathy were divided into three subgroups: mild (n = 13), moderate (n = 7), and severe (n = 4). Cerebral glucose metabolism manifested a trend toward increase, and the structure of cranial (18)F-fluorodeoxyglucose positron emission tomography images became clear with increased gestational age, especially at ≥37 weeks. Uptakes of (18)F-fluorodeoxyglucose in the ≥37-week group were significantly higher than in the ≤32-week group (P < 0.01). Cerebral glucose metabolism changed significantly in neonatal hypoxic-ischemic encephalopathy, and was either unbalanced bilaterally or relatively low at all sites. Moreover, uptakes of (18)F-fluorodeoxyglucose were significantly lower in severe than in mild and medium hypoxic-ischemic encephalopathy (P < 0.05). Cerebral glucose metabolism, as measured by (18)F-fluorodeoxyglucose positron emission tomography, may prove useful for estimating brain development and injury in newborn infants, and its clinical values need further investigation.

摘要

通过(18)F-氟代脱氧葡萄糖正电子发射断层扫描测量不同胎龄和伴有新生儿缺氧缺血性脑病的婴儿的脑葡萄糖代谢。将 36 名不同胎龄且无脑损伤的早产儿和足月儿分为 4 个亚组:≤32 周(n=4)、33-34 周(n=5)、35-36 周(n=12)和≥37 周(n=15)。将 24 名患有缺氧缺血性脑病的新生儿分为 3 个亚组:轻度(n=13)、中度(n=7)和重度(n=4)。脑葡萄糖代谢呈增加趋势,随着胎龄的增加,颅(18)F-氟代脱氧葡萄糖正电子发射断层扫描图像的结构变得清晰,尤其是在≥37 周时。≥37 周组的(18)F-氟代脱氧葡萄糖摄取量明显高于≤32 周组(P<0.01)。新生儿缺氧缺血性脑病的脑葡萄糖代谢明显改变,双侧或各部位均呈不平衡或相对低代谢。此外,重度缺氧缺血性脑病组的(18)F-氟代脱氧葡萄糖摄取量明显低于轻度和中度缺氧缺血性脑病组(P<0.05)。(18)F-氟代脱氧葡萄糖正电子发射断层扫描测量的脑葡萄糖代谢可能有助于估计新生儿的脑发育和损伤,其临床价值需要进一步研究。

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