PROTON MRS AT TERM AGE IS NOT PREDICTIVE OF NEURODEVELOP OUTCOME IN VLBW INFANTS

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。极低出生体重（VLBW）早产儿出现神经系统异常的风险增加，包括认知功能差、学习成绩下降、视力障碍、听力障碍和脑瘫。1H磁共振波谱（MRS）定量测量大脑各个区域的特定代谢物，已被证明可以预测窒息新生儿的神经发育结果。本回顾性研究的目的是评估近期1H MRS对VLBW早产儿18-24月龄神经发育结局的预测作用。方法和讨论：患者队列由36名婴儿组成，从9月01日至9月03日扫描，符合纳入标准：出生体重？1510g，胎龄？32周，月经后35-43周扫描年龄。在1.5 T扫描仪上进行MRI/MRS检查。在两个感兴趣的区域分析代谢物谱：1)左右丘脑和基底节区，2)左右皮层。对胆碱（Ch）、肌酸和磷酸肌酸（Cr）、n -乙酰天冬氨酸（NAA）峰进行积分，计算Ch/Cr、NAA/Cr和NAA/Ch比值。在18-24个月时采用贝利婴儿发育量表II中的精神发展指数（MDI）和精神运动发展指数（PDI）对患者进行评估。根据MDI和PDI评分，将患者分为两个结果组，正常组(？85)和异常（<85）。致谢：儿科研究学会，卢卡斯基金会，NIH RR09784, CA48269

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Introduction: Very low birth weight (VLBW) preterm infants are at an increased risk of neurological abnormalities, including poor cognitive function, decreased academic achievement, visual disability, hearing impairments, and cerebral palsy. 1H magnetic resonance spectroscopy (MRS), which quantitatively measures specific metabolites in various regions of the brain, has been shown to predict neurodevelopmental outcome in term, asphyxiated newborns. The purpose of this retrospective study was to evaluate near term 1H MRS in predicting neurodevelopmental outcome at 18-24 months in VLBW preterm infants. Methods and Discussion: The patient cohort was comprised of 36 infants scanned from 9/01-9/03 who met the inclusion criteria: birth weight ?1510g, gestational age ?32 weeks, and scan age of 35-43 postmenstrual weeks. MRI/MRS was performed on a 1.5 T scanner. Metabolite spectra were analyzed in two regions of interest: 1) the combined left and right thalamus and basal ganglia, and 2) the left and right cortex. Choline (Ch), creatine and phosphocreatine (Cr), and N-acetylaspartate (NAA) peaks were integrated and the ratios of Ch/Cr, NAA/Cr, and NAA/Ch were calculated. Patients were assessed at 18-24 months by the Mental Developmental Index (MDI) and the Psychomotor Developmental Index (PDI) of the Bayley Scales of Infant Development II. Based on their MDI and PDI scores, patients were divided into two outcome groups for each index, normal (? 85) and abnormal (<85). Acknowledgements: Pediatric Research Society, Lucas Foundation, NIH RR09784, CA48269