Kong Xiang-Bo, Qin Fan-Yue, Duan Wen-Li, Lu Lin, Guo Xiao-Chan, Xue Yan-Ran, Hong Yin-Gang, Xu Fa-Lin
Department of Neonatology, Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2025 Jun 15;27(6):661-667. doi: 10.7499/j.issn.1008-8830.2501047.
To explore the relationship between white matter injury (WMI) and cerebral perfusion in preterm infants using arterial spin labeling (ASL).
A total of 293 preterm infants (gestational age <34 weeks) hospitalized at the Third Affiliated Hospital of Zhengzhou University between June 2022 and June 2024 were included. After achieving clinical stability, the infants underwent brain magnetic resonance imaging (MRI) and ASL. Based on MRI findings, infants were classified into WMI (=66) and non-WMI (=227) groups. Cerebral perfusion parameters were compared between groups, and the association between WMI and perfusion alterations was evaluated.
The WMI group showed a higher incidence of mild intraventricular hemorrhage (IVH) than the non-WMI group (<0.05). Significantly lower cerebral perfusion was observed in the WMI group across bilateral frontal, temporal, parietal, and occipital lobes, as well as the basal ganglia and thalamus (<0.05). After adjusting for gestational age, corrected gestational age at ASL scan, and mild IVH, WMI remained significantly associated with reduced regional perfusion (<0.05).
WMI in preterm infants correlates with localized cerebral hypoperfusion. ASL-detected perfusion abnormalities may provide novel insights into WMI pathogenesis.
采用动脉自旋标记（ASL）技术探讨早产儿白质损伤（WMI）与脑灌注之间的关系。
纳入2022年6月至2024年6月在郑州大学第三附属医院住院的293例早产儿（胎龄<34周）。临床稳定后，对婴儿进行脑磁共振成像（MRI）和ASL检查。根据MRI结果，将婴儿分为WMI组（=66例）和非WMI组（=227例）。比较两组之间的脑灌注参数，并评估WMI与灌注改变之间的关联。
WMI组轻度脑室内出血（IVH）的发生率高于非WMI组（<0.05）。在WMI组中，双侧额叶、颞叶、顶叶和枕叶以及基底神经节和丘脑的脑灌注明显较低（<0.05）。在调整胎龄、ASL扫描时的矫正胎龄和轻度IVH后，WMI仍与局部灌注减少显著相关（<0.05）。
早产儿的WMI与局部脑灌注不足相关。ASL检测到的灌注异常可能为WMI的发病机制提供新的见解。
