Wang Yin-Juan, Liu Sha-Sha, Liu Yan-Chao, Li Xiao-Nan, Zhang Rui-Li, Xu Fa-Lin
Department of Neonatology, Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2020 Oct;22(10):1079-1084. doi: 10.7499/j.issn.1008-8830.2004236.
To assess white matter development in preterm infants with bronchopulmonary dysplasia (BPD) using fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of diffusion tensor imaging (DTI).
Ninety-six infants with a gestational age of ≤32 weeks and a birth weight of <1 500 g who were admitted to the neonatal intensive care unit within 24 hours after birth from August 2016 to April 2019 and underwent head MRI and DTI before discharge were enrolled. According to the discharge diagnosis, they were divided into BPD group with 48 infants and non-BPD group with 48 infants. The two groups were compared in terms of FA and ADC values of the same regions of interest on DTI image.
There were no significant differences in the incidence rates of periventricular/intraventricular hemorrhage, periventricular leukomalacia, and punctate white matter lesions between the two groups (P>0.05). Compared with the non-BPD group, the BPD group had significantly lower FA values and significantly higher ADC values of the posterior limb of the internal capsule, the splenium of the corpus callosum, the occipital white matter, the cerebellum, and the cerebral peduncle (P<0.05). Compared with the non-BPD group, the BPD group had a significantly higher frequency of apnea, a significantly higher proportion of infants with pneumonia or mechanical ventilation, and a significantly longer duration of assisted ventilation (P<0.05).
BPD may has potential adverse effects to white matter development in preterm infants, leading to delayed white matter development. Therefore, it is necessary to pay attention to the neurological function of these infants.
采用扩散张量成像（DTI）的分数各向异性（FA）和表观扩散系数（ADC）值评估支气管肺发育不良（BPD）早产儿的白质发育情况。
纳入2016年8月至2019年4月出生后24小时内入住新生儿重症监护病房、胎龄≤32周且出生体重<1500g、出院前接受头部MRI和DTI检查的96例婴儿。根据出院诊断，将其分为BPD组48例和非BPD组48例。比较两组DTI图像上相同感兴趣区域的FA和ADC值。
两组间脑室周围/脑室内出血、脑室周围白质软化和点状白质病变的发生率无显著差异（P>0.05）。与非BPD组相比，BPD组内囊后肢、胼胝体压部、枕叶白质、小脑和脑桥的FA值显著降低，ADC值显著升高（P<0.05）。与非BPD组相比，BPD组呼吸暂停的发生率显著更高，肺炎或机械通气婴儿的比例显著更高，辅助通气时间显著更长（P<0.05）。
BPD可能对早产儿白质发育有潜在不良影响，导致白质发育延迟。因此，有必要关注这些婴儿的神经功能。
