Skranes J S, Vik T, Nilsen G, Smevik O, Andersson H W, Rinck P, Brubakk A M
Department of Pediatrics, University Hospital of Trondheim, Norway.
Neuropediatrics. 1993 Oct;24(5):256-62. doi: 10.1055/s-2008-1071553.
Thirty-one (77.5%) of a year cohort of 40 surviving infants with birth weight < 1500 grams were seen on follow-up examination at one year of corrected age. At neurological evaluation 20 infants were normal (Group 1), seven infants were considered at risk (Group 2), and four infants had cerebral palsy (Group 3). Assessment on the Bayley Scales gave significantly lower mean scores in Group 3 compared with Group 1, both on the Mental Index (63 versus 102, p < 0.001) and on the Psychomotor Index (PDI) (60 versus 94, p < 0.005). Mean PDI score in Group 2 was significantly lower than in Group 1 (74 versus 94, p < 0.005). Cerebral MRI was performed in 27 infants. Of the 19 infants in Group 1 examined with MRI, 14 infants showed deviating changes in both myelin deposition and maturation (2). In all 14 infants the central occipital white matter was affected and in three infants also the centrum semiovale, both areas correspond to predilection sites for periventricular leukomalacia (PVL). Five infants had irregular shape of the occipital horns of the lateral ventricles. These findings may also represent the end stages of PVL (4). Only four out of seven infants were examined with MRI in Group 2. However, three infants had deviating myelination and three had irregular shape of the posterior horns. In Group 3 all infants were examined with MRI and all had deviating myelination and irregular and slightly dilated posterior horn. There was a significant correlation between abnormally dilated occipital horns seen with MRI, and cerebral palsy and low scores on the Denver and the Bayley tests.(ABSTRACT TRUNCATED AT 250 WORDS)
在一个校正年龄为一岁的随访检查中,对出生体重<1500克的40名存活婴儿中的31名(77.5%)进行了检查。在神经学评估中,20名婴儿正常(第1组),7名婴儿被认为有风险(第2组),4名婴儿患有脑瘫(第3组)。贝利量表评估显示,第3组的平均得分在心理指数(63对102,p<0.001)和心理运动指数(PDI)(60对94,p<0.005)方面均显著低于第1组。第2组的平均PDI得分显著低于第1组(74对94,p<0.005)。对27名婴儿进行了脑部MRI检查。在第1组接受MRI检查的19名婴儿中,14名婴儿在髓鞘沉积和成熟方面均出现异常变化(2)。在所有14名婴儿中,枕叶中央白质均受影响,3名婴儿的半卵圆中心也受影响,这两个区域均对应脑室周围白质软化症(PVL)的好发部位。5名婴儿侧脑室枕角形状不规则。这些发现也可能代表PVL的终末期(4)。第2组的7名婴儿中只有4名接受了MRI检查。然而,3名婴儿有髓鞘形成异常,3名婴儿后角形状不规则。第3组的所有婴儿均接受了MRI检查,所有婴儿均有髓鞘形成异常,后角不规则且轻度扩张。MRI显示的枕角异常扩张与脑瘫以及丹佛和贝利测试的低分之间存在显著相关性。(摘要截断于250字)