Department of Neonatology, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands.
Brain Center Rudolf Magnus, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands.
Pediatr Res. 2018 May;83(5):1004-1010. doi: 10.1038/pr.2018.10. Epub 2018 Mar 21.
BackgroundPreterm birth is associated with an increased risk of cerebellar injury. The aim of this study was to assess the impact of cerebellar hemorrhages (CBH) on cerebral white matter microstructural tissue organization and cerebellar volume at term-equivalent age (TEA) in extremely preterm infants. Furthermore, we aimed to evaluate the association between CBH and neurodevelopmental outcome in late infancy.MethodsA total of 24 preterm infants with punctate CBH were included and each matched to two preterm control infants. T1-, T2-weighted images and diffusion-weighted imaging were acquired on a 3T magnetic resonance imaging (MRI) system. Regions of interest were drawn on a population-specific neonatal template and automatically registered to individual fractional anisotropy (FA) maps. Brain volumes were automatically computed. Neurodevelopmental outcome was assessed using the Bayley scales of Infant and Toddler Development at 2 years of corrected age.ResultsCBHs were not significantly related to FA in the posterior limb of the internal capsule and corpus callosum or to cerebellar volume. Infants with CBH did not have poorer neurodevelopmental outcome compared with control infants.ConclusionThese findings suggest that the impact of mild CBH on early macroscale brain development may be limited. Future studies are needed to assess the effects of CBH on long-term neurodevelopment.
早产与小脑损伤的风险增加有关。本研究旨在评估在极早产儿中,胎龄相当(TEA)时小脑出血(CBH)对大脑白质微观组织结构和小脑体积的影响。此外,我们旨在评估 CBH 与婴儿晚期神经发育结局之间的关联。
共纳入 24 例点状 CBH 的早产儿,每位早产儿均匹配了 2 例早产儿对照。在 3T 磁共振成像(MRI)系统上采集 T1-、T2 加权图像和弥散加权成像。在特定人群的新生儿模板上绘制感兴趣区,并自动将其注册到个体各向异性分数(FA)图上。自动计算脑容量。采用贝利婴幼儿发展量表在矫正年龄 2 岁时评估神经发育结局。
CBH 与后内囊和胼胝体的后肢或小脑体积的 FA 无显著相关性。与对照婴儿相比,有 CBH 的婴儿神经发育结局并未更差。
这些发现表明,轻度 CBH 对早期宏观脑发育的影响可能有限。未来的研究需要评估 CBH 对长期神经发育的影响。