White Matter Injury in Term Newborns With Neonatal Encephalopathy
White Matter Injury in Term Newborns With Neonatal Encephalopathy
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DOI：
10.1203/pdr.0b013e31818912d2
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发表时间：
2009-01-01
影响因子：
3.6
通讯作者：
Miller, Steven P.
中科院分区：
文献类型：
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作者：
Li, Amanda M.;Chau, Vann;Miller, Steven P.
白色物质损伤（白质损伤）是早产儿磁共振成像检测到的脑损伤的特征性模式。局灶性非囊性增生在足月新生儿中越来越多地被认识到。本研究的目的是描述发生局灶性非囊性脑病的48名足月新生儿在72 - 12小时的生活与磁共振成像研究队列，并确定这种模式的损伤的临床危险因素。11名新生儿（23%; 95% CI 11-35）被发现患有腹泻（4名轻微，3名中度和4名重度）。11例新生儿中有10例在表观扩散系数图上表现为弥散受限。胎儿宫内窘迫的严重程度增加与出生时胎龄较低相关（p = 0.05），但与出生体重较低无关。与队列中的其他新生儿相比，患有癫痫的新生儿有较轻的脑病和较少的临床癫痫发作。其他脑损伤被认为是在三个I I新生儿：基底核为主的损伤模式在一个和皮质中风。这些发现表明，足月新生儿的脑损伤是在出生时获得的，脑成熟状态是这种脑损伤模式的重要决定因素。（Pediatr Res 65：85-89，2009）
White matter injury (WMI) is the characteristic pattern of brain injury detected on magnetic resonance imaging in the premature newborn. Focal noncystic WMI is increasingly recognized in populations of term newborns. The aim of this study was to describe the occurrence of focal noncystic WMI in a cohort of 48 term newborns with encephalopathy studied with magnetic resonance imaging at 72 12 h of life, and to identify clinical risk factors for this pattern of injury. Eleven newborns (23%; 95% CI 11-35) were found to have WMI (four minimal, three moderate, and four severe). In 10 of the 11 newborns, the WMI was associated with restricted diffusion on apparent diffusion coefficient maps. An increasing severity of WMI was associated with lower gestational age at birth (p = 0.05), but not lower birth weight. Newborns with WMI had milder encephalopathy and fewer clinical seizures relative to other newborns in the cohort. Other brain injuries were seen in three of the I I newborns: basal nuclei predominant pattern of injury in one and cortical strokes in two. These findings suggest that WMI in the term newborn is acquired near birth and that the state of brain maturation is an important determinant of this pattern of brain injury. (Pediatr Res 65: 85-89, 2009)