Schindler Tim, Gilbert Yasmin, Jayatilake Sonali, Stevenson Gordon, Oei Ju Lee, Welsh Alec
Faculty of Medicine, University of New South Wales, Sydney, Australia.
Department of Newborn Care, Royal Hospital for Women, Sydney, Australia.
Pediatr Res. 2016 Oct;80(4):573-6. doi: 10.1038/pr.2016.106. Epub 2016 May 16.
The preterm brain is susceptible to changes in blood flow. Using power Doppler images, digital imaging techniques have been developed to measure the total amount of blood flow in a defined area, giving the index: fractional moving blood volume (FMBV). The aim of this study was to investigate temporal changes in basal ganglia perfusion during the transitional period after birth.
Twenty-four preterm infants were examined with serial cranial ultrasounds at four time points during the first 48 h of life. FMBV was calculated using power Doppler images at each time point.
All infants had analyzable data and FMBV was successfully calculated at all time points. Twenty-three of the 24 infants had an increasing trend in FMBV over time. The median FMBV increased from 17% at 6 h to 25% at 48 h. One-way repeated measures ANOVA showed a significant increase in values at P < 0.001 at each of the four time points.
We have demonstrated changes in basal ganglia blood flow as the cerebral circulation adapts to extrauterine life. With further investigation, this technique may be useful in the assessment of preterm circulatory adaptation, either alone or in conjunction with other modes of evaluating cerebral blood flow.
早产儿的大脑易受血流变化的影响。利用能量多普勒图像,已开发出数字成像技术来测量特定区域的血流总量,得出分数移动血容量(FMBV)这一指标。本研究的目的是调查出生后过渡期基底节灌注的时间变化。
对24名早产儿在出生后48小时内的四个时间点进行连续的头颅超声检查。在每个时间点使用能量多普勒图像计算FMBV。
所有婴儿均有可分析的数据,且在所有时间点均成功计算出FMBV。24名婴儿中有23名的FMBV随时间呈上升趋势。FMBV的中位数从6小时时的17%增加到48小时时的25%。单向重复测量方差分析显示,在四个时间点的每一个时间点,数值均有显著增加,P < 0.001。
我们已经证明,随着脑循环适应宫外生活,基底节血流会发生变化。通过进一步研究,该技术可能有助于评估早产儿的循环适应情况,无论是单独使用还是与其他评估脑血流的方式联合使用。