Akasaka Manami, Kamei Atsushi, Araya Nami, Matsumoto Atsushi, Konishi Yu, Sotodate Genichiro, Shirasawa Satoko, Toya Yukiko, Kasai Takeo, Chida Shoichi, Sasaki Makoto
Department of Pediatrics, Iwate Medical University.
Magn Reson Med Sci. 2016;15(2):187-92. doi: 10.2463/mrms.mp.2015-0041. Epub 2015 Nov 13.
To investigate temporal changes in brain metabolites during the first year of life in preterm infants using multivoxel proton magnetic resonance spectroscopy ((1)H-MRS).
Seventeen infants born at 29 (25-33) gestational week (median, range) weighing 1104 (628-1836) g underwent 1.5-T multivoxel (1)H-MRS at 42 postconceptional week (PCW) and at 3, 6, 9, and 12 months after. We measured N-acetyl aspartate (NAA)/creatine (Cr), choline (Cho)/Cr, myo-inositol (Ins)/Cr, NAA/Cho, and Ins/Cho ratios in the frontal lobe (FL) and basal ganglia and thalamus (BG + Th). Linear regression analyses were performed to identify longitudinal changes in infants showing normal imaging findings and normal development. We also evaluated ratios of subjects with abnormal imaging findings and/or development using the 95% confidence intervals (CIs) of regression equations in normal subjects.
In the 13 infants with normal development, NAA/Cr and NAA/Cho ratios showed significant positive correlations with PCWs in the FL (r = 0.64 and 0.83, respectively, both P < 0.01) and BG + Th (r = 0.79 and 0.87, respectively, both P < 0.01), while Cho/Cr and Ins/Cr ratios revealed significant negative correlations with PCWs in the FL (r =-0.69 and -0.58, respectively, both P < 0.01) and BG + Th (r =-0.74 and -0.72, respectively, both P < 0.01). Ins/Cho ratios in the FL did not significantly correlate with PCWs (r =-0.19, P = 0.18), while those in the BG + Th showed significant negative correlation with PCWs (r =-0.44, P < 0.01). The metrics in the abnormal group were within the normal group 95% CIs in all periods except a few exceptions.
Longitudinal multivoxel MRS is able to detect temporal changes in major brain metabolites during the first year of life in preterm infants.
使用多体素质子磁共振波谱（(1)H-MRS）研究早产儿出生后第一年脑代谢物的时间变化。
17名孕29（25 - 33）周（中位数，范围）出生、体重1104（628 - 1836）g的婴儿在孕42周龄（PCW）以及之后的3、6、9和12个月接受了1.5-T多体素(1)H-MRS检查。我们测量了额叶（FL）、基底神经节和丘脑（BG + Th）中的N-乙酰天门冬氨酸（NAA）/肌酸（Cr）、胆碱（Cho）/Cr、肌醇（Ins）/Cr、NAA/Cho和Ins/Cho比值。进行线性回归分析以确定影像学检查结果正常且发育正常的婴儿的纵向变化。我们还使用正常受试者回归方程的95%置信区间（CIs）评估了影像学检查结果异常和/或发育异常的受试者的比值。
在13名发育正常的婴儿中，FL中NAA/Cr和NAA/Cho比值与PCW呈显著正相关（分别为r = 0.64和0.83，均P < 0.01），BG + Th中也是如此（分别为r = 0.79和0.87，均P < 0.01），而FL中Cho/Cr和Ins/Cr比值与PCW呈显著负相关（分别为r = -0.69和 -0.58，均P < 0.01），BG + Th中也是如此（分别为r = -0.74和 -0.72，均P < 0.01）。FL中Ins/Cho比值与PCW无显著相关性（r = -0.19，P = 0.18），而BG + Th中的Ins/Cho比值与PCW呈显著负相关（r = -0.44，P < 0.01）。除少数例外情况外，异常组的各项指标在所有时期均在正常组的95% CIs范围内。
纵向多体素MRS能够检测早产儿出生后第一年主要脑代谢物的时间变化。
