Wang Liangbing, Zhuo Yubo, Lin Fang, Wan Xueqing, Yang Guohui, He Jianlong
Department of Neonatology, The University of Hong Kong, Shenzhen Hospital, Shenzhen 518053, China.
Department of Pharmacy, The University of Hong Kong, Shenzhen Hospital, Shenzhen 518053, China.
Diagnostics (Basel). 2025 Aug 30;15(17):2206. doi: 10.3390/diagnostics15172206.
The aim of this study is to investigate the changes in quantitative indices of brain volume and cortex development in preterm infants with enlarged subarachnoid space (ESS). A single-center retrospective cohort study was performed in Hong Kong University-Shenzhen Hospital from November 2014 to November 2023, involving 200 preterm infants whose brain MRI images were available. Parameters including the volume of cerebrospinal fluid (CSF), brain tissues, total intracranial cavity (ICC), and key indices of cortex maturation (surface area, cortical thickness, cortical volume, mean curvature) were compared between the groups with ESS and without ESS. The retrospective nature of this study may introduce selection bias in the process of enrolling preterm infants with ESS. The groups with severe and mild ESS had a significantly greater ICC volume than the group without ESS (severe: 384.66 ± 30.33 [ < 0.001]; mild: 374.25 ± 26.45 [ < 0.001] vs. no ESS: 356.78 ± 26.03), and the difference was mostly due to the gap in extra-CSF volume among the three groups (severe: 74.20 ± 5.1 and mild: 55.36 ± 3.8 vs. no ESS: 40.54 ± 4.3, ≤ 0.001). Only the volume of parenchyma of the severe-ESS group was significantly different (severe: 302.35 ± 26.43 vs. no ESS: 312.27 ± 20.75, = 0.003). Regarding indices of cortex maturation, only the mean curvature showed a significant difference between the three groups, and most of the significant clusters were located around the parietal and temporal lobes. ESS may be associated with impaired early brain maturation in preterm infants after birth. A further neurodevelopmental follow-up study is needed.
本研究旨在调查蛛网膜下腔增宽（ESS）的早产儿脑容量和皮质发育定量指标的变化。2014年11月至2023年11月在香港大学深圳医院进行了一项单中心回顾性队列研究，纳入200例有脑部MRI图像的早产儿。比较了有ESS组和无ESS组的脑脊液（CSF）、脑组织、总颅腔（ICC）体积以及皮质成熟的关键指标（表面积、皮质厚度、皮质体积、平均曲率）。本研究的回顾性性质可能在纳入ESS早产儿的过程中引入选择偏倚。重度和轻度ESS组的ICC体积显著大于无ESS组（重度：384.66±30.33[<0.001]；轻度：374.25±26.45[<0.001] vs. 无ESS：356.78±26.03），差异主要源于三组间脑外CSF体积的差距（重度：74.20±5.1，轻度：55.36±3.8 vs. 无ESS：40.54±4.3，≤0.001）。只有重度ESS组的实质体积有显著差异（重度：302.35±26.43 vs. 无ESS：312.27±20.75，=0.003）。关于皮质成熟指标，只有平均曲率在三组间存在显著差异，且大多数显著簇位于顶叶和颞叶周围。ESS可能与早产儿出生后早期脑成熟受损有关。需要进一步进行神经发育随访研究。
