Radiologic-pathologic evidence of brain injury: hypoperfusion in the Papez circuit results in poor neurodevelopmental outcomes in neonatal hypoxic ischemic encephalopathy.
Radiologic-pathologic evidence of brain injury: hypoperfusion in the Papez circuit results in poor neurodevelopmental outcomes in neonatal hypoxic ischemic encephalopathy.
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脑损伤的放射病理学证据：帕佩斯回路灌注不足导致新生儿缺氧缺血性脑病神经发育结果不佳
DOI：
10.1007/s00381-020-04795-0
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发表时间：
2021-01
期刊：
影响因子：
--
通讯作者：
Hwang M
中科院分区：
文献类型：
--
作者：
Zheng Q;Viaene AN;Freeman CW;Hwang M
目的探讨新生儿缺氧缺血性脑病(HIE)Papez环脑损伤的放射病理学表现，并将其与远期神经发育结局进行相关性分析。比较14例无发育迟缓的新生儿(平均年龄8.2 ± 7.2d)和6例有发育迟缓的新生儿(平均年龄13.1 ± 8.0d)的脑血流值。另一组新生儿(平均年龄10 ± 6.8d)死后脑组织进行了4次组织病理学研究。结果有发育迟缓的HIE患儿与无发育迟缓的HIE患儿相比，Papez环脑血流灌注明显降低。在穹隆(p= 0.002)、内嗅皮质(p= 0.048)、杏仁核(p= 0.036)、海马体(p= 0.033)和丘脑(p= 0.036)的Papez环路结构中，ASL灌注值降低。在新生儿HIE尸检标本中，可见缺氧性(嗜酸性)神经元、反应性星形胶质细胞和白质稀疏，为HIE的影像表现提供了病理学依据。结论灌注加权成像和组织病理学显示，新生儿Papez环易发生缺氧缺血损伤。这为在婴儿期启动的神经精神疾病进化的可能的非家族机制提供了新的曙光，并提高了早期识别高危儿童的可能性。
PurposeTo provide radiologic-pathologic correlation of brain injury in the Papez circuit in hypoxic-ischemic encephalopathy (HIE) neonates and correlate radiologic findings with long-term neurodevelopmental outcomes.MethodsTwenty full-term HIE neonates were evaluated. Cerebral blood flow (CBF) values, obtained through pulsed arterial spin labeling (ASL) perfusion-weighted MRI, were compared by permutation test to identify brain regions with statistically significant perfusion changes between 14 HIE neonates without evidence of developmental delay by Bayley-III (mean age 8.2 ± 7.2 days) and 6 HIE neonates with evidence of developmental delay (mean age 13.1 ± 8.0 days). Four histopathologic studies on specimens were taken from post-mortem brains of another group of infants (mean age 10 ± 6.8 days) with HIE. The infants were not the same ones who had MRIs.ResultsSignificantly decreased perfusion in Papez circuit was found in HIE neonates with developmental delay compared with HIE neonates without delay. Decreased ASL perfusion values were seen in Papez circuit structures of the fornix (p= 0.002), entorhinal cortex (p= 0.048), amygdala (p= 0.036), hippocampus (p= 0.033), and thalamus (p= 0.036). In autopsy specimens of neonates with HIE, anoxic (eosinophilic) neurons, reactive astrocytes, and white matter rarefaction were observed in these regions, providing pathology correlation to the imaging findings of HIE.ConclusionThe Papez circuit is susceptible to hypoxic-ischemic injury in neonates as demonstrated by perfusion-weighted imaging and histopathology. This sheds new light onto a possible non-familial mechanism of neuropsychiatric disease evolution initiated in the infant period and raises the potential for early identification of at-risk children.
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DOI：
10.1001/archneurpsyc.1937.02260220069003
发表时间：
1937-10-01
影响因子：
--
作者：
Papez, JW
通讯作者：
Papez, JW
影响因子：
2.7
作者：
Delcour, Maxime;Russier, Michael;Coq, Jacques-Olivier
通讯作者：
Coq, Jacques-Olivier
影响因子：
5.1
作者：
Miller, SP;Ramaswamy, V;Ferriero, DM
通讯作者：
Ferriero, DM
影响因子：
2.5
作者：
Cavusoglu, Mustafa;Pfeuffer, Josef;Uludag, Kamil
通讯作者：
Uludag, Kamil
影响因子：
--
作者：
Bubb, Emma J;Kinnavane, Lisa;Aggleton, John P
通讯作者：
Aggleton, John P