先天性心脏病新生儿的白质损伤：一项扩散张量成像研究。
White matter injury in newborns with congenital heart disease: a diffusion tensor imaging study.
作者信息
Mulkey Sarah B, Ou Xiawei, Ramakrishnaiah Raghu H, Glasier Charles M, Swearingen Christopher J, Melguizo Maria S, Yap Vivien L, Schmitz Michael L, Bhutta Adnan T
机构信息
Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
出版信息
Pediatr Neurol. 2014 Sep;51(3):377-83. doi: 10.1016/j.pediatrneurol.2014.04.008. Epub 2014 Apr 12.
BACKGROUND
Brain injury is observed on cranial magnetic resonance imaging preoperatively in up to 50% of newborns with congenital heart disease. Newer imaging techniques such as diffusion tensor imaging provide sensitive measures of the white matter integrity. The objective of this study was to evaluate the diffusion tensor imaging analysis technique of tract-based spatial statistics in newborns with congenital heart disease.
METHODS
Term newborns with congenital heart disease who would require surgery at less than 1 month of age were prospectively enrolled (n = 19). Infants underwent preoperative and postoperative brain magnetic resonance imaging with diffusion tensor imaging. Tract-based spatial statistics, an objective whole-brain diffusion tensor imaging analysis technique, was used to determine differences in white matter fractional anisotropy between infant groups. Term control infants were also compared with congenital heart disease infants. Postmenstrual age was equivalent between congenital heart disease infant groups and between congenital heart disease and control infants.
RESULTS
Ten infants had preoperative brain injury, either infarct or white matter injury, by conventional brain magnetic resonance imaging. The technique of tract-based spatial statistics showed significantly lower fractional anisotropy (P < 0.05, corrected) in multiple major white matter tracts in the infants with preoperative brain injury compared with infants without preoperative brain injury. Fractional anisotropy values increased in the white matter tracts from the preoperative to the postoperative brain magnetic resonance imaging correlating with brain maturation. Control infants had higher fractional anisotropy in multiple white matter tracts compared with infants with congenital heart disease.
CONCLUSION
Tract-based spatial statistics is a valuable diffusion tensor imaging analysis technique that may have better sensitivity in detecting white matter injury compared with conventional brain magnetic resonance imaging in term newborns with congenital heart disease.
背景
在先天性心脏病新生儿中，术前头颅磁共振成像检查发现脑损伤的比例高达50%。诸如扩散张量成像等更新的成像技术能够提供对白质完整性的敏感测量。本研究的目的是评估基于纤维束的空间统计学扩散张量成像分析技术在先天性心脏病新生儿中的应用。
方法
前瞻性纳入1个月龄内需要手术治疗的先天性心脏病足月儿（n = 19）。婴儿在术前和术后接受了带有扩散张量成像的脑磁共振成像检查。采用基于纤维束的空间统计学这一客观的全脑扩散张量成像分析技术，来确定婴儿组之间白质各向异性分数的差异。足月儿对照组婴儿也与先天性心脏病婴儿进行了比较。先天性心脏病婴儿组之间以及先天性心脏病婴儿组与对照组婴儿之间的孕龄相当。
结果
通过传统脑磁共振成像检查，10名婴儿术前存在脑损伤，包括梗死或白质损伤。基于纤维束的空间统计学技术显示，与无术前脑损伤的婴儿相比，术前有脑损伤的婴儿多个主要白质纤维束中的各向异性分数显著降低（P < 0.05，校正后）。从术前到术后脑磁共振成像，白质纤维束中的各向异性分数值增加，这与脑成熟相关。与先天性心脏病婴儿相比，对照组婴儿多个白质纤维束中的各向异性分数更高。
结论
基于纤维束的空间统计学是一种有价值的扩散张量成像分析技术，与传统脑磁共振成像相比，在检测先天性心脏病足月儿的白质损伤方面可能具有更高的敏感性。
Zotero 插件