摘要
目的观察早产儿脑白质损伤(WMD)的影像学特征,探讨其与神经发育的关系。方法选取2014年8月~2016年8月秦皇岛市妇幼保健院收治的62例早产儿WMD患儿作为观察组,根据损伤类型分为局灶性WMD组(点簇状病灶组、线状病灶组)和弥漫性WMD组,另选取30名健康早产儿及30名健康足月新生儿分别作为对照组和足月组。分析早产儿WMD的影像学表现与神经发育的关系。结果 62例WMD患儿中局灶性WMD 48例(点簇状病灶36例、线状病灶12例),弥漫性WMD 14例;出生30 d后,33例患儿病灶消失,21例病灶面积减小,8例出现白质软化(PVL)。观察组患儿矫正胎龄40周时的新生儿行为神经评分(NBNA)及出生后3个月的运动发育指数(PDI)和(MDI)评分均显著高于对照组和足月组(P<0.05);点簇状病灶组患儿的NBNA、PDI和MDI评分均显著高于线状病灶组和弥漫性WMD组(P<0.05);复查时病灶消失组患儿的PDI和MDI评分显著高于病灶面积减少组和PVL组(P<0.05)。结论新生儿WMD患儿的MRI特征与近期神经发育存在一定相关性,在患儿神经发育预后状况评估中具有重要价值。
Objective To observe the imaging features of white matter injury （WMD） in premature infants, in order to explore its relationship with neurodevelopment. Methods From August 2014 to August 2016, 62 cases of preterm in- fants with WMD admitted in Maternal ＆ Child Health Care Hospital of Qinhuangdao were selected as the observation group, and the infants were divided into focal WMD group （cluster lesion group, linear lesion group） and diffuse WMD group, according to the type of injury. Then 30 cases of healthy preterm infants and full-term newborns were selected as control group and full-term group respectively. The relationship between WMD imaging and neurodevelopment was analyzed. Results There were 48 cases of focal WMD, in which 36 cases were cluster lesions and 12 cases were linear lesions, and 14 cases of diffuse WMD among 62 cases of WMD infants. 30 days after the birth, lesions of 33 cases was disappeared, lesions of 21 cases was decreased and lesions of 8 cases was developed into PVL. The scores of NBNA, PDI and MDI of the observation group were significantly higher than those of the control group and full-term group at 40th week of gestational age or 3 months after the birth （P 〈 0.05）. The NBNA, PDI and MDI scores of infants in clus- ter lesion grop were significantly higher than those in linear lesion group and diffuse WMD group （P 〈 0.05）. The PDI score and MDI score of the infants in lesion disappeared group were significantly higher than those in the lesion reduc- tion group and PVL group （P 〈 0.05）. Conclusion The MRI features of neonates with WMD have a certain correlation with the recent neurodevelopment, which is of great value in the assessment of neurodevelopmental prognosis.
作者
张洪涛
ZHANG Hongtao(Department of Radiology, Maternal ＆ Child Health Care Hospital of Qinhuangdao, Hebei Province, Qinhuangdao 066000, Chin)
出处
《中国医药导报》
CAS
2017年第13期113-116,F0004,共5页
China Medical Herald
基金
河北省秦皇岛市科学技术局项目(201602A054)
关键词
早产儿
脑白质损伤
磁共振成像
弥漫加权成像
神经发育
Premature infants
White matter damage
Magnetic resonance imaging
Diffusion-weighted imaging
Neu-rodevelopment
