Magnetic resonance imaging assessment of brain maturation in preterm neonates with punctate white matter lesions
Magnetic resonance imaging assessment of brain maturation in preterm neonates with punctate white matter lesions
复制标题
DOI：
10.1007/s00234-006-0176-y
复制
发表时间：
2007-02-01
期刊：
影响因子：
2.8
通讯作者：
Mosca, Fabio
中科院分区：
文献类型：
--
作者：
Ramenghi, Luca A.;Fumagalli, Monica;Mosca, Fabio
简介 足月经后年龄 (PMA) 的弥散张量成像和体积磁共振 (MR) 成像显示，早期白质 (WM) 损伤会影响早产儿的大脑成熟。本研究的目的是使用传统 MRI 定量评估有或没有轻度 WM 损伤（点状 WM 损伤，PWML）的早产儿的大脑成熟度。方法使用先前验证的评分系统（总成熟评分，TMS）对大脑发育进行定量评估，该系统利用四个参数（进行性髓鞘形成和皮质内折叠、神经胶质细胞迁移带和生发基质组织的进行性退化）。 PWML 被定义为 T1 加权图像上信号增加和 T2 加权图像上信号减少的病灶，但没有囊性变的证据。将 22 名足月 PMA 时患有 PWML 的早产儿（PWML 组）与 22 名 MR 表现正常的匹配对照进行比较。结果 两组在胎龄、出生体重和 PMA 方面具有可比性。 PWML 组的 TMS 显着低于对照组（平均 TMS 12.44 +/- 2.31 vs 14.00 +/- 1.44；P= 0.011）。 PWML 婴儿的髓鞘形成（平均 2.76 +/- 0.42 PWML 组 vs 3.32 +/- 0.55 对照组，P= 0.003）和皮质折叠（平均 3.64 +/- 0.79 vs 4.09 +/- 0.43，P= 0.027）似乎显着延迟。 结论 传统 MRI 似乎能够量化大脑成熟的形态变化患有 PWML 的早产儿；髓鞘形成延迟和皮质内折叠减少似乎是最重要的方面。
Introduction Early white matter (WM) injury affects brain maturation in preterm infants as revealed by diffusion tensor imaging and volumetric magnetic resonance (MR) imaging at term postmenstrual age (PMA). The aim of the study was to assess quantitatively brain maturation in preterm infants with and without milder forms of WM damage ( punctate WM lesions, PWML) using conventional MRI.Methods Brain development was quantitatively assessed using a previously validated scoring system ( total maturation score, TMS) which utilizes four parameters ( progressive myelination and cortical infolding, progressive involution of glial cell migration bands and germinal matrix tissue). PWML were defined as foci of increased signal on T1-weighted images and decreased signal on T2-weighted images with no evidence of cystic degeneration. A group of 22 preterm infants with PWML at term PMA ( PWML group) were compared with 22 matched controls with a normal MR appearance.Results The two groups were comparable concerning gestational age, birth weight and PMA. TMS was significantly lower in the PWML group than in the control group ( mean TMS 12.44 +/- 2.31 vs 14.00 +/- 1.44; P= 0.011). Myelination ( mean 2.76 +/- 0.42 PWML group vs 3.32 +/- 0.55 control group, P= 0.003) and cortical folding (3.64 +/- 0.79 vs 4.09 +/- 0.43, P= 0.027) appeared to be significantly delayed in babies with PWML.Conclusion Conventional MRI appears able to quantify morphological changes in brain maturation of preterm babies with PWML; delayed myelination and reduced cortical infolding seem to be the most significant aspects.