新生儿行为神经评估联合磁共振弥散张量成像在评估早产儿脑白质发育中的作用。
Role of Neonatal Behavioral Neurological Assessment combined with magnetic resonance diffusion tensor imaging in evaluating white matter development in preterm infants.
机构信息
Department of Neonatology, Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China (Xu F-L, Email: xufalin72@126. com).
出版信息
Zhongguo Dang Dai Er Ke Za Zhi. 2021;23(9):916-921. doi: 10.7499/j.issn.1008-8830.2106005.
OBJECTIVES
To study the correlation of fractional anisotropy (FA) on magnetic resonance diffusion tensor imaging with Neonatal Behavioral Neurological Assessment (NBNA) score in preterm infants, and to study the role of FA in evaluating white matter development from the perspective of imaging.
METHODS
A prospective study was performed for 98 preterm infants who were admitted to the Neonatal Intensive Care Unit of the Third Affiliated Hospital of Zhengzhou University within 24 hours after birth from October 2016 to January 2020. According to the results of NBNA, they were divided into an abnormal group with 51 infants (NBNA score <37) and a normal group with 47 infants (NBNA score ≥37). The FA values of 10 regions of interest were collected and compared between the two groups. The correlations of FA value and umbilical arterial blood gas pH value with the NBNA score were analyzed.
RESULTS
Compared with the normal group, the abnormal group had significantly lower FA value of the posterior limb of the internal capsule and umbilical arterial blood pH (<0.05). The FA value of the posterior limb of the internal capsule and umbilical arterial blood pH were positively correlated with the NBNA score (=0.584 and 0.604 respectively, <0.001), and the FA value of the posterior limb of the internal capsule was positively correlated with umbilical arterial blood pH (=0.426, <0.05).
CONCLUSIONS
The FA value of the posterior limb of the internal capsule can quantitatively reflect white matter development in preterm infants and is correlated with the NBNA score. The combination of the two indices can help to evaluate white matter development in preterm infants more accurately and objectively. .
目的
研究磁共振弥散张量成像各向异性分数（FA）与早产儿新生儿行为神经评估（NBNA）评分的相关性，从影像学角度探讨 FA 对评估早产儿脑白质发育的作用。
方法
采用前瞻性研究方法，选取 2016 年 10 月至 2020 年 1 月在郑州大学第三附属医院新生儿重症监护病房出生后 24 小时内入住的 98 例早产儿为研究对象。根据 NBNA 评分结果将其分为异常组（NBNA 评分<37 分）51 例和正常组（NBNA 评分≥37 分）47 例。采集并比较两组 10 个感兴趣区的 FA 值，分析 FA 值与脐动脉血气 pH 值与 NBNA 评分的相关性。
结果
与正常组比较，异常组内囊后肢及脐动脉血气 pH 值的 FA 值明显降低（<0.05）。内囊后肢及脐动脉血气 pH 值的 FA 值与 NBNA 评分呈正相关（=0.584 和 0.604，均<0.001），内囊后肢 FA 值与脐动脉血气 pH 值呈正相关（=0.426，<0.05）。
结论
内囊后肢 FA 值能定量反映早产儿脑白质发育情况，与 NBNA 评分相关，两者联合能更准确、客观地评估早产儿脑白质发育情况。
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