Keunen K, Kersbergen K J, Groenendaal F, Isgum I, de Vries L S, Benders M J N L
Department of Neonatology, Wilhelmina Children's Hospital, Medical Center Utrecht,The Netherlands.
J Matern Fetal Neonatal Med. 2012 Apr;25 Suppl 1:89-100. doi: 10.3109/14767058.2012.664343.
To evaluate the clinical value of neonatal brain tissue segmentation in preterm infants according to the literature.
A structured literature search was undertaken in MEDLINE/Pubmed. This included all publications on volumetric brain tissue assessment in preterm infants at term-equivalent age (TEA) compared to brain tissue volumes of term-born infants, related to perinatal risk factors or related to neurodevelopmental outcome.
Sixteen prospective cohort studies, described in 30 articles, fulfilled the criteria. Preterm infants displayed total and regional brain tissue alterations compared to healthy, term-born controls. These alterations seemed more prominent with decreasing gestational age. White matter injury, intraventricular haemorrhage, postnatal corticosteroid therapy, intra-uterine growth retardation and chronic lung disease were frequently associated with volume changes. Associations between volume alterations at TEA and neurodevelopmental outcome in early childhood were shown in a few studies.
Preterm birth is associated with brain tissue volume alterations that become more pronounced in the presence of perinatal risk factors and white matter injury. Moreover, associations between volumetric alterations as early as TEA and long-term neurodevelopmental impairments are scarce.
根据文献评估早产儿脑组织分割的临床价值。
在MEDLINE/Pubmed数据库中进行结构化文献检索。检索内容包括所有关于足月等效年龄（TEA）的早产儿脑组织体积评估与足月儿脑组织体积比较的出版物，这些出版物涉及围产期危险因素或神经发育结局。
16项前瞻性队列研究（在30篇文章中描述）符合标准。与健康足月儿对照组相比，早产儿表现出全脑和局部脑组织改变。随着胎龄降低，这些改变似乎更为明显。白质损伤、脑室内出血、产后皮质类固醇治疗、宫内生长受限和慢性肺病常与体积变化相关。少数研究显示了TEA时的体积改变与儿童早期神经发育结局之间的关联。
早产与脑组织体积改变有关，在存在围产期危险因素和白质损伤时，这种改变会更加明显。此外，早在TEA时的体积改变与长期神经发育障碍之间的关联很少。
