Tortora Domenico, Mattei Peter Angelo, Navarra Riccardo, Panara Valentina, Salomone Rita, Rossi Andrea, Detre John A, Caulo Massimo
ITAB-Institute of Advanced Biomedical Technologies, University "G. d'Annunzio", Via Luigi Polacchi 11, 66100 Chieti, Italy; Neuroradiology Unit, Istituto Giannina Gaslini, Via Gerolamo Gaslini 5, 16147 Genoa, Italy.
Ophthalmology Clinic, Department of Medicine and Aging Sciences, University "G. d'Annunzio", Via dei Vestini, 66100 Chieti, Italy.
Neuroimage Clin. 2017 May 26;15:401-407. doi: 10.1016/j.nicl.2017.05.023. eCollection 2017.
Abnormal brain perfusion is a critical mechanism in neonatal brain injury. The aim of the present study was to compare Cerebral Blood Flow (CBF) evaluated with ASL MRI in three groups of neonates: preterms without brain lesions on MRI (PN), preterms with periventricular white matter lesions (PNp) and term neonates with normal MRI (TN). The correlation between CBF and clinical outcome was explored.
The institutional review board approved this prospective study and waived informed consent. The perfusion ASL data from 49 consecutive preterm neonates (PN) studied at term-equivalent age and 15 TN were evaluated. Statistically significant differences in gray matter CBF were evaluated by using a linear mixed-model analysis and Mann-Whitney test. Logistic regression analysis was used to assess the relation between CBF and neuromotor outcome at 12 months.
Comparison of means indicated that the CBF of the whole brain were significantly higher in PN compared to TN ( = 0.011). This difference remained significant when considering the frontal ( = 0.038), parietal ( = 0.002), temporal ( = 0.030), occipital ( = 0.041) and cerebellar ( = 0.010) gray matter. In the PN group, lower CBF in basal ganglia was associated with a worse neuromotor outcome ( = 0.012).
ASL MRI demonstrated differences in brain perfusion of the basal ganglia between PN and TN. In PN, a positive correlation between CBF and neuromotor outcome was demonstrated in this area.
脑灌注异常是新生儿脑损伤的关键机制。本研究旨在比较三组新生儿通过动脉自旋标记磁共振成像（ASL MRI）评估的脑血流量（CBF）：MRI无脑损伤的早产儿（PN）、脑室周围白质损伤的早产儿（PNp）和MRI正常的足月儿（TN）。探讨CBF与临床结局之间的相关性。
机构审查委员会批准了这项前瞻性研究并豁免了知情同意。对49例在足月等效年龄研究的连续早产儿（PN）和15例TN的灌注ASL数据进行评估。采用线性混合模型分析和曼-惠特尼检验评估灰质CBF的统计学显著差异。采用逻辑回归分析评估12个月时CBF与神经运动结局之间的关系。
均值比较表明，PN组全脑CBF显著高于TN组（P = 0.011）。考虑额叶（P = 0.038）、顶叶（P = 0.002）、颞叶（P = 0.030）、枕叶（P = 0.041）和小脑（P = 0.010）灰质时，这种差异仍然显著。在PN组中，基底神经节较低的CBF与较差的神经运动结局相关（P = 0.012）。
ASL MRI显示PN和TN之间基底神经节的脑灌注存在差异。在PN组中，该区域CBF与神经运动结局呈正相关。
