Serial diffusion tensor imaging detects white matter changes that correlate with motor outcome in premature infants
Serial diffusion tensor imaging detects white matter changes that correlate with motor outcome in premature infants
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DOI：
10.1159/000105470
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发表时间：
2007-01-01
影响因子：
2.9
通讯作者：
Tan, Sidhartha
中科院分区：
文献类型：
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作者：
Drobyshevsky, Alexander;Bregman, Joanne;Tan, Sidhartha
本研究的目的是评估序列弥散张量MRI （DTI）对早产儿白质损伤和神经发育结局的预测价值。24例妊娠小于32周的婴儿分为对照组（n = 11）、轻度脑损伤伴1-2级脑室内出血组（n = 6）和重度脑损伤伴3-4级脑室内出血组（n = 4）。在妊娠30周和36周左右进行了系列DTI研究。计算分数各向异性（FA）和表观扩散系数。对12名婴儿的发育结果进行了随访。采用贝利婴儿发育量表进行发育测试，获得精神运动指数（表现发育指数）。重型损伤组第二次MRI中央、枕部白质、辐射冠区的表观扩散系数较高；与对照组相比，FA的光辐射较低。性能发育指数得分与第30周扫描时的FA呈相关，与内囊和枕部白质扫描间FA的变化呈负相关。30周时较低的FA值和较高的FA变化预示着2岁时较差的运动预后，这表明即使没有明显的损伤迹象，也可以在早产儿中检测到早期细微的白质损伤。版权所有(C) 2007 S. Karger AG，巴塞尔
The objective of the study was to assess predictive value of serial diffusion tensor MRI (DTI) for the white matter injury and neurodevelopmental outcome in a cohort of premature infants. Twenty-four infants less than 32 weeks' gestation were stratified to a control group (n = 11), mild brain injury with grades 1-2 of intraventricular hemorrhage (n = 6) and severe brain injury with grades 3-4 intraventricular hemorrhage (n = 4). Serial DTI studies were performed at around 30 and 36 weeks' gestation. Fractional anisotropy (FA) and apparent diffusion coefficient were calculated. Twelve infants were followed up for developmental outcome. Developmental testing was performed with the Bayley Scales of Infant Development to obtain psychomotor index (Performance Developmental Index). Apparent diffusion coefficient was higher in the severe injury group at the second MRI in the central and occipital white matter, and corona radiata; FA was lower in optic radiation compared to controls. Performance Developmental Indexscore correlated with FA on the scan taken at the 30th week and inversely with the change of FA between scans in internal capsule and occipital white matter. A low value of FA at 30 weeks and a higher change of FA predicted less favorable motor outcome at 2 years and suggests that early subtle white matter injury can be detected in premature infants even without obvious signs of injury. Copyright (C) 2007 S. Karger AG, Basel.