Ikuta Toshihiko, Mizobuchi Masami, Katayama Yoshinori, Yoshimoto Seiji, Ioroi Tomoaki, Yamane Masayuki, Morisawa Takeshi, Takatera Akihiro, Ueda Masaaki, Shibata Akio, Maeyama Kaori, Mandai Tsurue, Fujioka Kazumichi, Nishimura Noriyuki, Iijima Kazumoto, Morioka Ichiro
Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan; Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
Brain Dev. 2018 Oct;40(9):753-759. doi: 10.1016/j.braindev.2018.05.007. Epub 2018 May 25.
Asymmetric ventriculomegaly is often evident on brain magnetic resonance imaging (MRI) in very low birth weight infants (VLBWI) and is interpreted as white matter injury. However, no evaluation index for asymmetric left-right and anterior-posterior ventricular sizes has been established.
In this retrospective multicenter cohort study, brain T2-weighted MRI was performed at term-equivalent ages in 294 VLBWI born between 2009 and 2011. The value of a lateral ventricular index (LVI) to evaluate asymmetric ventricular size, as well as the relationship between the LVI value and walking at a corrected age of 18 months was investigated. At the level of the foramen of Monro in a horizontal slice, asymmetry between the left and right sides and between the anterior and posterior horns was identified by the corrected width and was detected by a low concordance rate and κ statistic value. An LVI representing the sum of the widths of the four horns of the lateral ventricle corrected for cerebral diameter was devised.
Asymmetric left-right and anterior-posterior ventricular sizes were confirmed. The LVI value was significantly higher in the non-walking VLBWI group (n = 39) than in the walking VLBWI group (n = 255; 18.2 vs. 15.8, p = 0.02). An LVI cut-off value of 21.5 was associated with non-walking. Multivariate analysis revealed that an LVI value >21.5 was an independent predictor of walking disability at the corrected age of 18 months (odds ratio 2.56, p = 0.008).
The LVI value calculated via MRI may predict walking disability at a corrected age of 18 months in VLBWI.
极低出生体重儿（VLBWI）的脑磁共振成像（MRI）常显示不对称性脑室扩大，被解释为白质损伤。然而，目前尚未建立评估左右侧及前后侧脑室大小不对称的评估指标。
在这项回顾性多中心队列研究中，对2009年至2011年出生的294例VLBWI在足月等效年龄时进行脑T2加权MRI检查。研究评估不对称脑室大小的侧脑室指数（LVI）的值，以及LVI值与18个月矫正年龄时行走能力之间的关系。在水平切片的室间孔层面，通过校正宽度识别左右侧及前后角之间的不对称性，并通过低一致性率和κ统计值进行检测。设计了一个代表侧脑室四个角宽度之和并经脑直径校正的LVI。
证实存在左右侧及前后侧脑室大小不对称。非行走的VLBWI组（n = 39）的LVI值显著高于行走的VLBWI组（n = 255；18.2对15.8，p = 0.02）。LVI临界值21.5与非行走相关。多变量分析显示，LVI值>21.5是18个月矫正年龄时行走障碍的独立预测因素（优势比2.56，p = 0.008）。
通过MRI计算的LVI值可能预测VLBWI在18个月矫正年龄时的行走障碍。
