影响极低出生体重儿头围与脑容量关系的临床因素。
Clinical Factors That Affect the Relationship between Head Circumference and Brain Volume in Very-Low-Birth-Weight Infants.
机构信息
Division of Neonatology, Maternal and Perinatal Center, Toyama University Hospital, Toyama, Japan.
The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD.
出版信息
J Neuroimaging. 2019 Jan;29(1):104-110. doi: 10.1111/jon.12558. Epub 2018 Sep 10.
BACKGROUND AND PURPOSE
Measuring head circumference (HC) in infants is an easy screening procedure with which to detect abnormalities in brain growth. It has been demonstrated that HC can predict total brain volume (TBV) in very-low-birth-weight (VLBW) infants. However, the correlation between HC and TBV was weaker than that observed in healthy term-born toddlers, suggesting that there are factors that influence the relationship between HC and TBV. The aim of this study was to identify the clinical risk factors that caused a deviation from the regression line obtained between HC and TBV.
METHODS
The study population was based on 37 VLBW infants, who underwent a clinical magnetic resonance imaging (MRI) examination at a term-equivalent age, during 2013-2015, at Toyama University Hospital. The HC and the TBV were both adjusted for sex, multiple births, and postmenstrual age. The relationship between TBV/HC and clinical characteristics was evaluated.
RESULTS
There was a positive correlation between HC and TBV (r = .58, P = .000168). Two clinical factors, the lower birth body weight (BBW) (r = .38, P = .02) and dolichocephaly (r = 0.46, P = .006), were identified as factors that negatively affected the TBV/HC ratio. After excluding infants with low BBW or with dolichocephaly, the correlation between HC and TBV was higher (r = .63).
CONCLUSIONS
Although HC has predictive value for TBV in VLBW infants, care should be taken in infants with low BBW (BBW less than 600 g) or dolichocephaly (MRI-based cranial index less than .68), which were related to overestimation of TBV.
背景与目的
测量头围（HC）是一种简单的筛查方法，可以检测到脑生长异常。已经证明，HC 可以预测极低出生体重（VLBW）婴儿的总脑体积（TBV）。然而，HC 与 TBV 之间的相关性比健康足月出生的幼儿要弱，这表明有一些因素会影响 HC 与 TBV 之间的关系。本研究旨在确定导致 HC 与 TBV 之间回归线偏离的临床危险因素。
方法
该研究人群基于 2013 年至 2015 年在富山大学医院接受了相当于胎龄的临床磁共振成像（MRI）检查的 37 名 VLBW 婴儿。HC 和 TBV 均按性别、多胎和孕周进行了调整。评估了 TBV/HC 与临床特征之间的关系。
结果
HC 与 TBV 之间存在正相关（r =.58，P =.000168）。两个临床因素，较低的出生体重（BBW）（r =.38，P =.02）和长头畸形（r = 0.46，P =.006），被确定为对 TBV/HC 比值有负面影响的因素。排除低 BBW 或长头畸形的婴儿后，HC 与 TBV 之间的相关性更高（r =.63）。
结论
尽管 HC 对 VLBW 婴儿的 TBV 具有预测价值，但应注意 BBW 较低（BBW 小于 600 g）或长头畸形（基于 MRI 的头指数小于.68）的婴儿，因为这些婴儿可能会导致 TBV 的高估。
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