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极低出生体重脑损伤早产儿的临床特征与磁共振成像总成熟度评分的相关性

Correlation between clinical features and total maturation score by magnetic resonance imaging in very low birth weight premature infants with brain injury.

作者信息

Zhu Dalin, Wang Manxia, Feng Fan, Nan Nan, Liu Yuefen, Shi Jinyun, Mao Baohong

机构信息

Department of Neurology, Lanzhou University Second Hospital, Lanzhou, China.

Department of Reproductive Medicine Center, Gansu Province Maternity and Child Care Hospital, Lanzhou, China.

出版信息

Ann Palliat Med. 2021 Feb;10(2):2089-2097. doi: 10.21037/apm-21-55.

Abstract

BACKGROUND

Brain injury in premature infants (BIPI) seriously affects the growth and development of preterm infants. Magnetic resonance imaging (MRI) has become an important method of assessing brain development. The aim of this study was to explore the correlation between clinical features and total maturation score (TMS) by MRI in very low birth weight (VLBW) preterm infants with brain injury at term postmenstrual age (PMA).

METHODS

A retrospective cohort of 65 cases of BIPI with VLBW and 40 normal control cases were included, and all cases underwent MRI examination. The 2 groups were assessed in terms of TMS and sub-parameters (myelination, cortical infolding, germinal matrix, bands of migrating glial cells), and the correlation between TMS and term PMA was also analyzed.

RESULTS

The TMS of the BIPI group was lower than that of the control group (P<0.01). The differences in myelination and cortical infolding were statistically significant (P<0.01). No significant differences in the germinal matrix and bands of migrating glial cells were found. The linear regression equation showing a positive correlation between TMS and term PMA in normal preterm infants was y=1.164x-28.888 (t=9.478, P=0.000).

CONCLUSIONS

TMS by conventional cranial MRI can objectively reflect the brain maturity and brain damage of premature infants, and is related to the term PMA.

摘要

背景

早产儿脑损伤(BIPI)严重影响早产儿的生长发育。磁共振成像(MRI)已成为评估脑发育的重要方法。本研究旨在探讨极低出生体重(VLBW)且在足月矫正胎龄(PMA)时发生脑损伤的早产儿的临床特征与MRI总成熟度评分(TMS)之间的相关性。

方法

纳入65例VLBW的BIPI病例回顾性队列及40例正常对照病例,所有病例均接受MRI检查。对两组进行TMS及子参数(髓鞘形成、皮质折叠、生发基质、迁移胶质细胞带)评估,并分析TMS与足月PMA之间的相关性。

结果

BIPI组的TMS低于对照组(P<0.01)。髓鞘形成和皮质折叠的差异具有统计学意义(P<0.01)。生发基质和迁移胶质细胞带未发现显著差异。正常早产儿中显示TMS与足月PMA呈正相关的线性回归方程为y=1.164x-28.888(t=9.478,P=0.000)。

结论

常规头颅MRI的TMS可客观反映早产儿的脑成熟度和脑损伤情况,且与足月PMA相关。

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