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应用三维超声评估早产儿从出生至校正胎龄期末的正常小脑生长。

Normal Cerebellar Growth by Using Three-dimensional US in the Preterm Infant from Birth to Term-corrected Age.

机构信息

From the Neonatology Unit (I.B.F., E.R.G., S.P.L.L.) and Research Unit (G.J.G., A.M.L.S.), University Hospital Puerta del Mar, Avda. Ana de Viya 21, Cádiz 11009, Spain; Nene Foundation (Neonatal Neurology Research Group), Madrid, Spain (I.B.F., S.P.L.L.); Department of Pediatrics, Faculty of Medicine, University of Cádiz, Cádiz, Spain (E.R.Z., J.L.M.); and Early Intervention, Health and Social Policies, Regional Government of Andalusia, Seville, Spain (R.C.F.C.).

出版信息

Radiology. 2018 Jul;288(1):254-261. doi: 10.1148/radiol.2018171956. Epub 2018 Apr 3.

Abstract

Purpose To establish cross-sectional and longitudinal reference values for cerebellar size in preterm infants with normal neuroimaging findings and normal 2-year neurodevelopmental outcome by using cranial ultrasonography (US). Materials and Methods This prospective study consecutively enrolled preterm infants admitted to a neonatal intensive care unit from June 2011 to June 2014 with a birth weight of less than or equal to 1500 g and/or gestational age (GA) of less than or equal to 32 weeks. They underwent weekly cranial US from birth to term-equivalent age and magnetic resonance (MR) imaging at term-equivalent age. The infants underwent neurodevelopmental assessments at age 2 years with Bayley Scales of Infant and Toddler Development, 3rd edition (BSID-III). Patients with adverse outcomes (death or abnormal neuroimaging findings and/or BSID-III score of <85) were excluded. The following measurements were performed: vermis height, craniocaudal diameter, superior width, inferior width, vermis area, and transcerebellar diameter. Statistical analyses were conducted by using multilevel analyses. Results A total of 137 infants with a mean GA at birth of 29.4 weeks (range, 25-32 weeks) were included. Transcerebellar diameter increased by 1.04 mm per week on average; vermis height and craniocaudal diameter increased by 0.55 mm and 0.59 mm, respectively. Superior vermian width increased by an average of 0.45 mm, whereas inferior vermian width increased by an average of 0.51 mm per week. Vermis area was found to increase by 0.22 cm per week on average. The sex effect was significant (female lower than male) for vermis height (P < .05), craniocaudal diameter (P < .05), inferior vermian width (P <. 05), and vermis area (P <. 05). Conclusion Cross-sectional and longitudinal reference values were established for cerebellar growth in preterm infants, which may be included in routine cranial US.

摘要

目的 通过头颅超声(US)为影像学正常且 2 岁神经发育结局正常的早产儿建立小脑大小的横断面和纵向参考值。

材料与方法 本前瞻性研究连续纳入 2011 年 6 月至 2014 年 6 月期间于新生儿重症监护病房住院的出生体重小于或等于 1500g 和/或胎龄(GA)小于或等于 32 周的早产儿。他们在出生至足月龄期间每周进行头颅 US 检查,在足月龄时进行磁共振成像(MR)检查。在 2 岁时,婴儿使用贝利婴幼儿发育量表第三版(BSID-III)进行神经发育评估。排除有不良结局(死亡或异常影像学发现和/或 BSID-III 评分<85)的患儿。进行了以下测量:蚓部高度、头尾径、上宽、下宽、蚓部面积和小脑横径。采用多级分析进行统计分析。

结果 共纳入 137 名平均胎龄为 29.4 周(范围 25-32 周)的患儿。小脑横径平均每周增加 1.04mm;蚓部高度和头尾径分别增加 0.55mm 和 0.59mm。上蚓部宽度平均增加 0.45mm,而下蚓部宽度平均每周增加 0.51mm。蚓部面积平均每周增加 0.22cm。蚓部高度(P<0.05)、头尾径(P<0.05)、下蚓部宽度(P<0.05)和蚓部面积(P<0.05)的性别效应有统计学意义(女性低于男性)。

结论 为影像学正常且 2 岁神经发育结局正常的早产儿建立了小脑生长的横断面和纵向参考值,这些参考值可能包含在常规头颅 US 中。

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