Semi-quantitative assessment of brain maturation by conventional magnetic resonance imaging in neonates with clinically mild hypoxic-ischemic encephalopathy.
Semi-quantitative assessment of brain maturation by conventional magnetic resonance imaging in neonates with clinically mild hypoxic-ischemic encephalopathy.
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DOI：
10.4103/0366-6999.151646
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发表时间：
2015-03-05
影响因子：
6.1
通讯作者：
Yang J
中科院分区：
文献类型：
--
作者：
Gao J;Sun QL;Zhang YM;Li YY;Li H;Hou X;Yu BL;Zhou XH;Yang J
轻度缺氧缺血性脑病（HIE）损伤正在成为新生儿脑部疾病的主要类型。本研究的目的是利用基于常规磁共振成像（MRI）的总成熟评分（TMS）来评估轻度HIE新生儿的脑成熟度。共纳入45例临床轻度HIE新生儿和45例匹配的对照新生儿。两组的胎龄、出生体重、出生后年龄和经后磁共振（MR）扫描年龄均相同。根据MR表现，将轻度HIE新生儿分为3个亚组：模式1，MR表现正常的新生儿；模式二：MR表现异常的早产儿；模式三：足月新生儿MR表现异常。采用颅磁刺激及其参数，渐进性髓鞘形成(M)、皮质内折(C)、生发基质组织(G)和胶质细胞迁移带(B)，评估脑成熟度，并比较HIE组与对照组之间的差异。轻度HIE组TMS平均值显著低于对照组（均数±标准差[SD] 11.62±1.53∶12.36±1.26,P < 0.001）。在TMS评分的4个参数中，轻度HIE组的M、C评分均显著低于对照组。轻度HIE三种模式中，模式1（10例）与对照组相比，TMS无显著差异，模式2（22例）、模式3（13例）的TMS均显著低于对照组(mean±SD 10.56±0.93∶11.48±0.55,P < 0.05；模式2（12.59±1.28∶13.25±1.29,P < 0.05）。模式II中M、C和GM得分显著下降，而模式III中只有C得分显著下降。颅磁刺激系统是一种基于常规MRI的检测临床轻度HIE脑成熟延迟的有效方法。常规MRI可以揭示不同类型轻度HIE在细微结构和发育过程上的不同发育迟缓。
Mild hypoxic-ischemic encephalopathy (HIE) injury is becoming the major type in neonatal brain diseases. The aim of this study was to assess brain maturation in mild HIE neonatal brains using total maturation score (TMS) based on conventional magnetic resonance imaging (MRI). Totally, 45 neonates with clinically mild HIE and 45 matched control neonates were enrolled. Gestated age, birth weight, age after birth and postmenstrual age at magnetic resonance (MR) scan were homogenous in the two groups. According to MR findings, mild HIE neonates were divided into three subgroups: Pattern I, neonates with normal MR appearance; Pattern II, preterm neonates with abnormal MR appearance; Pattern III, full-term neonates with abnormal MR appearance. TMS and its parameters, progressive myelination (M), cortical infolding (C), involution of germinal matrix tissue (G), and glial cell migration bands (B), were employed to assess brain maturation and compare difference between HIE and control groups. The mean of TMS was significantly lower in mild HIE group than it in the control group (mean ± standard deviation [SD] 11.62 ± 1.53 vs. 12.36 ± 1.26, P < 0.001). In four parameters of TMS scores, the M and C scores were significantly lower in mild HIE group. Of the three patterns of mild HIE, Pattern I (10 cases) showed no significant difference of TMS compared with control neonates, while Pattern II (22 cases), III (13 cases) all had significantly decreased TMS than control neonates (mean ± SD 10.56 ± 0.93 vs. 11.48 ± 0.55, P < 0.05; 12.59 ± 1.28 vs. 13.25 ± 1.29, P < 0.05). It was M, C, and GM scores that significantly decreased in Pattern II, while for Pattern III, only C score significantly decreased. The TMS system, based on conventional MRI, is an effective method to detect delayed brain maturation in clinically mild HIE. The conventional MRI can reveal the different retardations in subtle structures and development processes among the different patterns of mild HIE.