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足月相当年龄时脑磁共振成像对极早产儿学龄期神经发育结局的预测价值。

Predictive value of brain MRI at term-equivalent age in extremely preterm children on neurodevelopmental outcome at school-age.

作者信息

Garbi Aurélie, Sorin Gaelle, Coze Stéphanie, Resseguier Noémie, Brévaut-Malaty Véronique, Marret Stéphane, Muller Jean-Baptiste, Tosello Barthélémy, Gire Catherine

机构信息

Department of Neonatology, North Hospital, Chemin Des Bourrely, APHM University Hospital, 13015, Marseille, France.

Department of Neuroradiology, North Hospital, Chemin Des Bourrely, APHM University Hospital, 13015, Marseille, France.

出版信息

Brain Imaging Behav. 2022 Apr;16(2):878-887. doi: 10.1007/s11682-021-00559-9. Epub 2021 Oct 18.

Abstract

This study's objective was to correlate the abnormalities in brain MRIs performed at corrected-term age for minor or moderate neurocognitive disorders in children school-age born extremely premature (EPT) and without serious sequelae such as autism, cerebral palsy, mental impairment. Data were issued from a cross-sectional multicenter study (GP-Qol study, number NCT01675726). Clinical examination and psychometric assessments were performed when the children were between 7 and 10 years old during a day-long evaluation. Term-equivalent age brain MRIs on EPT were analyzed with a standardized scoring system. There were 114 children included in the study. The mean age at the time of evaluation, was 8.47 years old (± 0.70). 59% of children with at least one cognitive impairment and 53% who had a dysexecutive disorder. Only ten EPT (8.7%) presented moderate to severe white and grey matter abnormalities. These moderate to severe grey matter abnormalities were associated with at least two abnormal executive functions [OR 3.08 (95% CI 1.04-8.79), p = 0.04] and language delay [OR 3.25 (95% CI 1.03-9.80), p = 0.04]. These results remained significant in the multivariate analysis. Moderate to severe ventricular dilatation abnormalities (15%, n = 17) were associated with ideomotor dyspraxia [OR 7.49 (95% CI 1.48-35.95), p = 0.02] and remained significant in multivariate analysis [OR 11.2 (95% CI 1.45-131.4), p = 0.02]. Biparietal corrected diameters were moderate abnormal in 20% of cases (n = 23) and were associated to visuo spatial integration delay [OR 4.13 (95% CI 1.23-13.63), p = 0.02]. Cerebral MRI at term-equivalent age with scoring system analysis can provide information on long-term neuropsychological outcomes at school-age in EPTs children having no severe disability.

摘要

本研究的目的是将极早产(EPT)出生且无自闭症、脑瘫、智力障碍等严重后遗症的学龄儿童在矫正月龄时进行的脑部磁共振成像(MRI)异常情况与轻度或中度神经认知障碍相关联。数据来自一项横断面多中心研究(GP-Qol研究,编号NCT01675726)。在为期一天的评估中,当儿童7至10岁时进行临床检查和心理测量评估。使用标准化评分系统分析EPT儿童相当于足月年龄的脑部MRI。该研究纳入了114名儿童。评估时的平均年龄为8.47岁(±0.70)。59%的儿童至少有一项认知障碍,53%的儿童有执行功能障碍。只有10名EPT儿童(8.7%)出现中度至重度白质和灰质异常。这些中度至重度灰质异常与至少两项异常执行功能[比值比(OR)3.08(95%置信区间1.04-8.79),p = 0.04]和语言发育迟缓[OR 3.25(95%置信区间1.03-9.80),p = 0.04]相关。这些结果在多变量分析中仍然显著。中度至重度脑室扩张异常(15%,n = 17)与观念运动性失用症[OR 7.49(95%置信区间1.48-35.95),p = 0.02]相关,且在多变量分析中仍然显著[OR 11.2(95%置信区间1.45-131.4),p = 0.02]。20%的病例(n = 23)双侧顶叶校正直径中度异常,与视觉空间整合延迟相关[OR 4.13(95%置信区间1.23-13.63),p = 0.02]。采用评分系统分析足月年龄的脑部MRI能够为无严重残疾的EPT儿童学龄期的长期神经心理结果提供信息。

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