Lo Marcus, Kishimoto Jessica, Eagleson Roy, Bhattacharya Soume, de Ribaupierre Sandrine
Lawson Health Research Institute, London, ON, Canada.
Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Childs Nerv Syst. 2020 Mar;36(3):569-575. doi: 10.1007/s00381-019-04355-1. Epub 2019 Aug 29.
The aim of this study is to investigate whether ventricular volume in posthemorrhagic ventricle dilatation impacts neurodevelopmental outcome. Infants were scanned with 3D cranial ultrasound in the first few months of life, and their neurodevelopmental outcome at 4, 8, 12, and 24 months corrected age (CA) was examined.
Forty-nine infants who suffered an intraventricular hemorrhage (IVH) were enrolled in the study. Subjects were scanned multiple times during their stay in the neonatal intensive care unit. Images were manually segmented to measure total volume of the lateral ventricles, and the highest volume was taken. Infants with a volume ≤ 20 cc were considered low-volume (n = 33), and infants with a volume ≥ 40 cc were considered high-volume (n = 12). Developmental outcome was assessed at 4, 8, and 12 months CA with the Alberta Infant Motor Scale (AIMS) and Infant Neurological International Battery (Infanib), and at 24 months CA with the Bayley Scales of Infant Development 3e (BSID III).
Infants in the low-volume group had higher scores on the Infanib at 4 months CA, and on both the AIMS and Infanib at 8 and 12 months CA, even after controlling for gestational age, birth weight, and worst grade of IVH. We observed a trend where low-volume infants also scored higher on the cognitive and gross-motor subtests of the BSID III at 24 months CA.
Our results show that ventricular volume affects neurodevelopmental outcome in infants with IVH. This finding could guide the timing of future interventions, as earlier intervention may decrease the likelihood of adverse neurodevelopmental outcome.
本研究旨在调查出血后脑室扩张时的心室容积是否会影响神经发育结局。在婴儿出生后的头几个月用三维头颅超声对其进行扫描，并检查其在矫正年龄4个月、8个月、12个月和24个月时的神经发育结局。
49例发生脑室内出血（IVH）的婴儿纳入本研究。受试者在新生儿重症监护病房住院期间接受多次扫描。对图像进行手动分割以测量侧脑室的总体积，并取其最大体积。体积≤20立方厘米的婴儿被视为低容积组（n = 33），体积≥40立方厘米的婴儿被视为高容积组（n = 12）。在矫正年龄4个月、8个月和12个月时，使用艾伯塔婴儿运动量表（AIMS）和国际婴儿神经学综合量表（Infanib）评估发育结局；在矫正年龄24个月时，使用贝利婴儿发育量表第3版（BSID III）进行评估。
即使在控制了胎龄、出生体重和IVH的最严重分级后，低容积组婴儿在矫正年龄4个月时的Infanib评分较高，在矫正年龄8个月和12个月时的AIMS和Infanib评分均较高。我们观察到一种趋势，即低容积组婴儿在矫正年龄24个月时的BSID III认知和大运动子测试中得分也较高。
我们的结果表明，心室容积会影响IVH婴儿的神经发育结局。这一发现可为未来干预的时机提供指导，因为早期干预可能会降低不良神经发育结局的可能性。
