Battin M R, Maalouf E F, Counsell S J, Herlihy A H, Rutherford M A, Azzopardi D, Edwards A D
Department of Pediatrics, Imperial College School of Medicine, Hammersmith Hospital, London, England.
Pediatrics. 1998 Jun;101(6):957-62. doi: 10.1542/peds.101.6.957.
To investigate preterm infants, we have installed in our neonatal intensive care unit a dedicated magnetic resonance (MR) imaging system which was specifically designed for neonatal use. The aim of this study was to describe the MR appearances of the brain in preterm infants who were first scanned between 25 and 32 weeks gestational age (GA) and to outline changes to the brains of these infants between their first scan and term.
Preterm infants of 25 to 32 weeks GA were imaged using the 1T neonatal MR system (Oxford Magnet Technology, Eyensham, Oxfordshire, England/Picker International, Cleveland, OH). The scanning protocol included T1-weighted conventional spin echo (repetition time [TR], 600; echo time, 20 ms), inversion recovery fast spin echo (TR, 3530; effective echo time, 30; inversion time, 950 ms), and T2-weighted fast spin echo (TR, 3500; effective echo time, 208 ms) sequences.
Seventeen infants of median 28 weeks GA (range, 24 to 31 weeks) at birth were imaged a total of 53 times between birth and term. The median number of images per infant was two (range, 1 to 9). In infants of < 30 weeks GA, the germinal matrix was visualized at the margins of the lateral ventricles. It had a short T1 and short T2 and the bulk of it involuted at between 30 and 32 weeks GA. The white matter had a relatively homogeneous low signal except for bands of altered signal (probably originating from regions containing radial glia and migrating cells) which were most apparent anterolateral and posterolateral to the lateral ventricles. Myelination was seen in the posterior brainstem, cerebellum, and region of the ventrolateral nuclei of the thalamus. Infants had very little cortical folding at 25 weeks GA but this developed later in an orderly fashion.
The neonatal MR system allowed extremely preterm infants to be studied safely with MR imaging. The images acquired demonstrated the germinal matrix, early myelination, and early cortical folding. Evolution of these features was demonstrated with serial studies.
为研究早产儿，我们在新生儿重症监护病房安装了一台专门为新生儿设计的专用磁共振（MR）成像系统。本研究的目的是描述在孕龄（GA）25至32周首次进行扫描的早产儿大脑的MR表现，并概述这些婴儿从首次扫描到足月时大脑的变化。
使用1T新生儿MR系统（牛津磁体技术公司，英国牛津郡艾恩舍姆/皮克国际公司，俄亥俄州克利夫兰）对GA 25至32周的早产儿进行成像。扫描方案包括T1加权常规自旋回波序列（重复时间[TR]，600；回波时间，20 ms）、反转恢复快速自旋回波序列（TR，3530；有效回波时间，30；反转时间，950 ms）和T2加权快速自旋回波序列（TR，3500；有效回波时间，208 ms）。
17例出生时GA中位数为28周（范围24至31周）的婴儿在出生至足月期间共接受了53次成像。每个婴儿的图像中位数为2次（范围1至9次）。在GA小于30周的婴儿中，生发基质在侧脑室边缘可见。它具有短T1和短T2信号，其大部分在GA 30至32周时 involuted（此处原文有误，推测可能是 involuted，意为退化、消退）。除了信号改变的条带（可能起源于含有放射状胶质细胞和迁移细胞的区域）外，白质具有相对均匀的低信号，这些条带在侧脑室前外侧和后外侧最为明显。在脑桥后部、小脑和丘脑腹外侧核区域可见髓鞘形成。GA 25周时婴儿的皮质折叠很少，但后来以有序的方式发展。
新生儿MR系统使极早产儿能够安全地接受MR成像研究。所获得的图像显示了生发基质、早期髓鞘形成和早期皮质折叠。通过系列研究展示了这些特征的演变。
