Department of Radiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Institute of Neuroscience, Zhengzhou University, Zhengzhou, China.
Sci Rep. 2024 Mar 8;14(1):5709. doi: 10.1038/s41598-024-56148-5.
There is increasing evidence of abnormal neurodevelopmental outcomes in preterm infants with low-grade intraventricular hemorrhage (IVH). The purpose of the study was to explore whether brain microstructure and volume are associated with neuro-behavioral outcomes at 40 weeks corrected gestational age in preterm infants with low-grade IVH. MR imaging at term-equivalent age (TEA) was performed in 25 preterm infants with mild IVH (Papile grading I/II) and 40 control subjects without IVH. These subjects all had neonatal behavioral neurological assessment (NBNA) at 40 weeks' corrected age. Microstructure and volume evaluation of the brain were performed by using diffusion kurtosis imaging (DKI) and Synthetic MRI. Correlations among microstructure parameters, volume, and developmental outcomes were explored by using Spearman's correlation. In preterm infants with low-grade IVH, the volume of brain parenchymal fraction (BPF) was reduced. In addition, mean kurtosis (MK), fractional anisotropy (FA), radial kurtosis (RK), axial kurtosis (AK) in several major brain regions were reduced, while mean diffusivity (MD) was increased (P < 0.05). BPF, RK in the cerebellum, MK in the genu of the corpus callosum, and MK in the thalamus of preterm infants with low-grade IVH were associated with lower NBNA scores (r = 0.831, 0.836, 0.728, 0.772, P < 0.05). DKI and Synthetic MRI can quantitatively evaluate the microstructure alterations and brain volumes in preterm infants with low-grade IVH, which provides clinicians with a more comprehensive and accurate neurobehavioral assessment of preterm infants with low-grade IVH.
越来越多的证据表明，低级别脑室内出血（IVH）的早产儿存在神经发育异常的后果。本研究旨在探讨轻度 IVH（Papile 分级 I/II）早产儿的脑微观结构和体积是否与胎龄校正 40 周时的神经行为结局相关。在胎龄校正 40 周时，对 25 名轻度 IVH 早产儿（Papile 分级 I/II）和 40 名无 IVH 的对照组婴儿进行了足月等效期（TEA）的磁共振成像（MRI）检查。所有这些婴儿都在胎龄校正 40 周时进行了新生儿行为神经评估（NBNA）。通过扩散峰度成像（DKI）和合成 MRI 评估脑微观结构和体积。使用 Spearman 相关分析探讨微观结构参数、体积与发育结局之间的相关性。在患有低级别 IVH 的早产儿中，脑实质分数（BPF）的体积减少。此外，几个主要脑区的平均峰度（MK）、各向异性分数（FA）、径向峰度（RK）、轴向峰度（AK）降低，而平均扩散系数（MD）增加（P<0.05）。BPF、小脑的 RK、胼胝体膝部的 MK 和丘脑的 MK 与低级别 IVH 早产儿的 NBNA 评分较低有关（r=0.831，0.836，0.728，0.772，P<0.05）。DKI 和合成 MRI 可以定量评估患有低级别 IVH 的早产儿的微观结构改变和脑容量，为临床医生提供了更全面、更准确的低级别 IVH 早产儿神经行为评估。
