Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
Neonatology. 2019;115(3):226-233. doi: 10.1159/000494368. Epub 2019 Jan 22.
Preterm infants show a decreased tortuosity in all proximal segments of the cerebral vasculature at term-equivalent age (TEA). Recently MRI techniques were developed to measure cerebral blood flow (CBF) based on phase-contrast images.
We hypothesized that arterial CBF corrected for brain size differs between full-term and preterm infants at TEA.
344 infants without major brain abnormalities had a cranial MRI for clinical reasons including phase-contrast magnetic resonance angiography (PC-MRA) around TEA (mean 41.1 ± SD 1.2 weeks). This cohort consisted of 172 preterm infants (gestational age at birth 24.1-31.9 weeks) and 172 term-born infants (gestational age at birth 37.0-42.6 weeks). The total CBF in milliliters/minute was calculated by adding the blood flow of the carotid and basilar arteries, and compared to age at scan, body weight, and several parameters of estimated brain size.
After logarithmic transformation, total CBF was associated with body weight, estimated brain weight, head circumference, and 2D brain surface measurements at TEA. Total CBF was significantly (9-12%) higher in term compared to preterm infants after correction for 2D brain surface measurements, head circumference or postmenstrual age at MRI (p < 0.05).
Total CBF as measured by PC-MRA was associated with body and (estimated) brain weight and 2D brain surface measurements and was higher in term compared to preterm born infants.
早产儿在接近足月时所有大脑血管近端段的迂曲度都降低。最近，磁共振成像（MRI）技术已经发展到可以通过相位对比图像来测量脑血流量（CBF）。
我们假设在接近足月时，动脉 CBF 经脑容量校正后，在足月儿和早产儿之间存在差异。
344 名无明显脑部异常的婴儿因临床原因进行了头部 MRI 检查，包括接近足月时的相位对比磁共振血管造影（PC-MRA）（平均胎龄为 41.1±1.2 周）。该队列包括 172 名早产儿（胎龄 24.1-31.9 周）和 172 名足月儿（胎龄 37.0-42.6 周）。通过相加颈内动脉和基底动脉的血流来计算每分毫升的总 CBF，并将其与扫描时的年龄、体重和几个估计脑容量的参数进行比较。
对数转换后，总 CBF 与接近足月时的体重、估计脑重、头围和 2D 脑表面测量值相关。经 2D 脑表面测量值、头围或 MRI 时的校正胎龄校正后，总 CBF 在足月儿中明显（9-12%）高于早产儿（p＜0.05）。
通过 PC-MRA 测量的总 CBF 与体重和（估计）脑重及 2D 脑表面测量值相关，在足月儿中高于早产儿。
