Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.
Pediatr Res. 2023 Sep;94(3):979-986. doi: 10.1038/s41390-023-02567-5. Epub 2023 Mar 18.
Preterm birth adversely impacts brain development and contributes to neurodevelopmental impairment; the temporal lobe may be particularly vulnerable to the impact of very preterm (VP) birth. Yet, no prior magnetic resonance imaging (MRI) scoring system incorporated a method to quantify temporal lobe size in VP infants.
We developed and applied three metrics (temporal lobe length, extra-axial space, and temporal horn width) to quantify temporal lobe structure on term-equivalent brain MRIs obtained from 74 VP and 16 term infants. We compared metrics between VP and term infants and explored associations of each metric with perinatal risk factors.
All metrics had excellent reliability (intra-class correlation coefficient 0.62-0.98). VP infants had lower mean temporal lobe length (76.8 mm versus 79.2 mm, p = 0.02); however, the difference attenuated after correction for postmenstrual age. VP infants had larger temporal horn widths compared with term infants (2.6 mm versus 1.8 mm, p < 0.001). Temporal lobe length was positively associated with gestational age, birth weight, and male sex, and negatively associated with the duration of parenteral nutrition.
The proposed metrics are reliable and sensitive in distinguishing differences in temporal lobe development between VP and full-term infants.
We developed a novel method for quantifying temporal lobe size among very preterm infants at term equivalent using simple metrics performed on brain MRI. Temporal lobe metrics were reliable, correlated with brain volume from volumetric analysis, and were sensitive in identifying differences in temporal lobe development among preterm compared with term infants, specifically larger temporal horn size in preterm infants. This temporal lobe metric system will enable future work to delineate the perinatal and postnatal factors that impact temporal lobe growth, and better understand the relationship between temporal lobe disturbance and neurodevelopment in very preterm infants.
早产会对大脑发育产生不利影响，并导致神经发育障碍；颞叶可能特别容易受到极早产（VP）出生的影响。然而，以前的磁共振成像（MRI）评分系统没有一种方法可以量化 VP 婴儿的颞叶大小。
我们开发并应用了三种指标（颞叶长度、颅外腔和颞角宽度）来量化 74 名 VP 和 16 名足月婴儿的脑 MRI 上的颞叶结构。我们比较了 VP 和足月婴儿之间的指标，并探讨了每个指标与围产期危险因素的关联。
所有指标的可靠性均很高（组内相关系数 0.62-0.98）。VP 婴儿的平均颞叶长度较低（76.8 毫米与 79.2 毫米，p=0.02）；然而，在考虑了胎龄校正后，差异减弱。VP 婴儿的颞角宽度大于足月婴儿（2.6 毫米与 1.8 毫米，p<0.001）。颞叶长度与胎龄、出生体重和男性性别呈正相关，与静脉营养持续时间呈负相关。
所提出的指标在区分 VP 和足月婴儿颞叶发育差异方面具有可靠性和敏感性。
我们开发了一种使用 MRI 上的简单指标在脑 MRI 上量化 VP 婴儿等效足月时颞叶大小的新方法。颞叶指标可靠，与容积分析中的脑容量相关，并且能够敏感地区分早产儿与足月儿之间的颞叶发育差异，特别是早产儿的颞角较大。这个颞叶指标系统将使未来的工作能够描述影响颞叶生长的围产期和产后因素，并更好地理解极早产儿颞叶紊乱与神经发育的关系。
