A novel quantitative simple brain metric using MR imaging for preterm infants.
A novel quantitative simple brain metric using MR imaging for preterm infants.
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DOI：
10.3174/ajnr.a1309
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发表时间：
2009-01
期刊：
影响因子：
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通讯作者：
Inder TE
中科院分区：
文献类型：
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作者：
Nguyen The Tich S;Anderson PJ;Shimony JS;Hunt RW;Doyle LW;Inder TE
容积技术在早产儿中的应用揭示了脑容量的减少。这些定量数据在常规新生儿放射护理中不可用。本研究的目的是开发简单的大脑指标，比较早产儿和足月儿的大脑大小，并将这些指标与体积MR技术的脑体积相关联。研究了189例胎龄<30周或出生体重<1250 g的早产儿和36例足月儿的MR图像。在4个选定切片上系统评价了15个组织和液体测量值。结果与全脑、灰质、白色物质和CSF体积相关。早产儿的平均双额、双顶和小脑横径减小（分别为-11.6%; CI=-13.8至-9.3%;-12%，-14至-9.8%和-8.7%，-10.5至-7%），平均左心室直径增加（+22.3%; 2.9至41.6%）（p<0.01）。双额叶和双顶测量值与脑组织总体积之间存在较强的相关性，而脑室和半球间测量值的大小与CSF体积相关。观察者内部可靠性高（ICC >0.7），而观察者之间的一致性对于组织测量是可以接受的（ICC >0.6），但对于液体测量则较低（ICC <0.4）。足月年龄的简单脑测量显示，与足月婴儿相比，早产婴儿的脑直径较小，脑室大小增加。这些措施代表了一种可靠和易于应用的方法，以量化脑生长和评估脑萎缩的风险人群。
The application of volumetric techniques to preterm infants has revealed brain volume reductions. Such quantitative data are not available in routine neonatal radiological care. The objective of this study was to develop simple brain metrics to compare brain size in preterm and term infants, and correlate these metrics with brain volumes from volumetric MR techniques. MR images from 189 preterm infants <30 weeks’ gestational age or <1250 g birthweight scanned at term-equivalent age and 36 term infants were studied. Fifteen tissue and fluid measures were systematically evaluated on 4 selected slices. The results were correlated with total brain, grey matter, white matter and CSF volumes. The mean bifrontal, biparietal and transverse cerebellar diameters were reduced (−11.6 %; CI= −13.8 to −9.3%; −12%, −14 to −9.8% and −8.7%, −10.5 to −7% respectively) and the mean left ventricle diameter was increased (+22.3%; 2.9 to 41.6%) in preterm infants (p<0.01). Strong correlations were found between the bifrontal and biparietal measures with total brain tissue volume, while the size of the ventricles and the interhemispheric measure correlated with CSF volume. Intra-observer reliability was high (ICC >0.7), while inter-observer agreement was acceptable for tissue measures (ICC >0.6) but lower for fluid measures (ICC <0.4) Simple brain metrics at term-equivalent age showed smaller brain diameters and increased ventricle size in preterm infants compared with full term infants. These measures represent a reliable and easily applicable method to quantify brain growth and assess brain atrophy in this at-risk population.