早产儿纹状体-脑叶血管病：一种新的分类、临床关联和神经发育结局。
Lenticulostriate vasculopathy in preterm infants: a new classification, clinical associations and neurodevelopmental outcome.
机构信息
Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Department of Radiology, University of Texas Southwestern Medical Center and Children's Health System of Texas, Dallas, TX, USA.
出版信息
J Perinatol. 2018 Oct;38(10):1370-1378. doi: 10.1038/s41372-018-0206-8. Epub 2018 Aug 16.
OBJECTIVE
To examine the inter-rater reliability for the diagnosis of LSV on cranial ultrasound (cUS), determine the risk factors associated with LSV and its progression, and examine neurodevelopmental outcome.
STUDY DESIGN
Prospective case-control study of neonates ≤32wks of gestation assessed for LSV by serial cUS (n = 1351) between 2012 and 2014 and their neurodevelopment at 18-36mon-corrected age compared to controls.
RESULTS
Agreement for LSV on cUS improved from Κappa 0.4-0.7 after establishing definitive criteria and guidelines. BPD was the only variable associated with the occurrence and the progression of LSV. Cytomegalovirus (CMV) infection occurred in one neonate (1.5%). Neurodevelopmental outcome of neonates with LSV did not differ from controls.
CONCLUSIONS
Establishment of well-defined stages of LSV improves the reliability of the diagnosis and allows identification of neonates with progression of LSV. Although LSV was associated with BPD, it was not associated with congenital CMV infection.
目的
研究头颅超声（cUS）诊断脑室内出血（LSV）的观察者间可靠性，确定与 LSV 及其进展相关的危险因素，并检查神经发育结局。
研究设计
对 2012 年至 2014 年间通过连续 cUS 评估的≤32 周胎龄新生儿进行前瞻性病例对照研究（n=1351），并与对照组相比，在 18-36 月龄时评估其神经发育情况。
结果
在建立明确的标准和指南后，cUS 上 LSV 的一致性从 Kappa 0.4-0.7 提高。BPD 是唯一与 LSV 发生和进展相关的变量。一名新生儿（1.5%）发生巨细胞病毒（CMV）感染。LSV 新生儿的神经发育结局与对照组无差异。
结论
明确 LSV 的分期可提高诊断的可靠性，并可识别进展性 LSV 的新生儿。尽管 LSV 与 BPD 相关，但与先天性 CMV 感染无关。
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