Huang C C, Liu C C
Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan.
Early Hum Dev. 1993 Apr;33(1):9-19. doi: 10.1016/0378-3782(93)90169-u.
To determine whether there is any difference in the growth of the cerebellar vermis between appropriate-for-gestational-age (AGA) and small-for-gestational-age (SGA) infants during fetal life, the central vermian area (Cva) of the cerebellum and its anterior-posterior distance (Vap) and superior-inferior distance (Vsi) were measured by midsagittal cerebral ultrasonography in 218 newborns within 24 h of birth. Patients with congenital infections and malformations were excluded. One-hundred twenty-one infants were AGA and 97 SGA. Best curve-fit of second-degree polynominal equations were found between gestational age and Cva, Vap, Vsi in both AGA and SGA neonates. Among them, Cva correlated best with gestational age in both AGA and SGA newborns. Comparing the head circumference (HC), Cva, Vap and Vsi between AGA and SGA neonates in the four gestational age subgroups (24-28, 29-33, 34-37 and 38-41 weeks), significant differences in HC were found in the 34-37 weeks (P < 0.01) and 38-41 weeks (P < 0.001) subgroups. But the significant differences in Cva and Vsi were found only in the 38-41 weeks subgroup. There is more accelerated growth in vermis from 34 to 41 weeks of gestation than that from 24 to 33 weeks. Comparing with AGA, the non-fetal cause of intrauterine growth retarded newborns demonstrate growth retardation in the cerebellar vermis only at late gestation. The cerebellar vermis measured by cranial ultrasound may serve as part of the neurological maturation assessments in newborns. Further work is needed to establish the normogram for the cerebellar vermis in newborns, and to assess the neurodevelopmental outcomes of those with an abnormal vermis.
为了确定适于胎龄（AGA）和小于胎龄（SGA）婴儿在胎儿期小脑蚓部生长是否存在差异，对218例出生后24小时内的新生儿进行了经中矢状脑超声检查，测量小脑中央蚓部面积（Cva）及其前后径（Vap）和上下径（Vsi）。排除患有先天性感染和畸形的患者。121例婴儿为AGA，97例为SGA。在AGA和SGA新生儿中，均发现胎龄与Cva、Vap、Vsi之间存在二次多项式方程的最佳曲线拟合。其中，AGA和SGA新生儿中Cva与胎龄的相关性最佳。比较四个胎龄亚组（24 - 28周、29 - 33周、34 - 37周和38 - 41周）AGA和SGA新生儿的头围（HC）、Cva、Vap和Vsi，发现34 - 37周亚组（P < 0.01）和38 - 41周亚组（P < 0.001）的HC存在显著差异。但仅在38 - 41周亚组中发现Cva和Vsi存在显著差异。妊娠34至41周蚓部的生长比24至33周加速更多。与AGA相比，非胎儿原因导致的宫内生长受限新生儿仅在妊娠晚期小脑蚓部出现生长迟缓。经颅骨超声测量的小脑蚓部可作为新生儿神经成熟度评估的一部分。需要进一步开展工作来建立新生儿小脑蚓部的正常图表，并评估蚓部异常者的神经发育结局。
