MRI, MRSI, AND DTI OF BRAIN INJURY IN PRETERM NEONATES

描述(由申请人提供)：这项拨款建议将最先进的神经成像技术的使用扩展到早产儿脑损伤的研究中。目前，超声波是最常用的对早产儿大脑进行成像的技术；然而，在尸检和MRI检测到的脑白质病变中，超声波只能检测到不到三分之一。此外，超声波的发现不能解释已报道的高达50%的早产儿的神经发育问题。初步研究表明，磁共振(MR)成像在早产儿中是安全的，解剖MR成像在检测早产儿非空洞性脑白质损伤方面比超声更敏感，扩散张量成像(DTI)和磁共振波谱成像(MRSI)评估发育中大脑的微观结构和代谢，对正常发育中断非常敏感，尤其是在进行顺序研究时。这笔赠款将扩展这些初步研究：(1)确定磁共振成像评估的大脑代谢变化是否比标准临床和实验室参数与神经运动、眼科检查和贝利婴儿发育II量表评估的30个月运动、视觉和认知结果之间有更强的相关性；(2)确定DTI评估的大脑微结构变化是否比标准临床和实验室参数与通过神经运动评分、眼科检查和贝利婴儿发育II量表评估的30个月运动、视觉和认知结果有更强的相关性；以及(3)确定通过磁共振成像评估的大脑代谢变化，DTI评估的大脑微结构的改变与30个月的神经发育结局有更强的相关性，如神经运动评分、眼科评估和贝利婴儿发育量表II。

DESCRIPTION (provided by applicant): This grant proposes to extend the use of state of the art neuroimaging techniques to the study of brain injury in preterm neonates. Currently, ultrasound is the technique most commonly used to image the brains of preterm neonates; however, ultrasound detects fewer than one third of the white matter lesions detected at autopsy and by MRI. Furthermore, ultrasound findings do not account for the neurodevelopmental problems that have been reported in up to 50% of prematurely born infants. Preliminary studies show that magnetic resonance (MR) imaging is safe in preterm neonates, that anatomic MR imaging has greater sensitivity than ultrasound in detecting noncavitary white matter injuries in preterm neonates, and that diffusion tensor imaging (DTI) and MR spectroscopic imaging (MRSI), which assess the microstructure and metabolism of the developing brain, are very sensitive to disruption of normal development, particularly when sequential studies are performed. This grant will extend these preliminary studies (1) to determine whether alterations of cerebral metabolism, as assessed by MRSI have a stronger association than standard clinical and laboratory parameters with 30 month motor, visual, and cognitive outcome as assessed by neuromotor, ophthalmologic examination, and Bayley's Scales of Infant Development II, (2) to determine whether alterations of cerebral microstructure, as assessed by DTI, have a stronger association than standard clinical and laboratory parameters with 30 month motor, visual, and cognitive outcome assessed by neuromotor scores, ophthalmologic examination, and the Bayley Scales of Infant Development II, and (3) to determine whether alterations of cerebral metabolism, as assessed by MRSI, or alterations of cerebral microstructure, as assessed by DTI, has a stronger association with 30 month neurodevelopmental outcome, as assessed by neuromotor score, ophthalmologic evaluation, and the Bayley's Scales of Infant Development II.