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

描述（由申请人提供）：该补助金旨在将最先进的神经影像学技术的使用扩展到早产儿脑损伤的研究。目前，超声是最常用于早产儿大脑成像的技术;然而，超声检测不到尸检和MRI检测到的白色病变的三分之一。此外，超声检查结果不能解释高达50%的早产儿报告的神经发育问题。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腔性白色损伤方面比超声具有更高的灵敏度，并且评估发育中大脑微观结构和代谢的扩散张量成像（DTI）和MR波谱成像（MRSI）对正常发育的破坏非常敏感，特别是当进行连续研究时。这项资助将扩展这些初步研究（1）以确定大脑代谢的改变，如MRSI评估的，是否比标准临床和实验室参数与30个月的运动，视觉和认知结果有更强的关联，如神经运动，眼科检查和贝利婴儿发育量表II评估的，（2）以确定大脑微观结构的改变，如DTI评估的，比标准临床和实验室参数与30个月运动、视觉和认知结果有更强的相关性，所述结果通过神经运动评分、眼科检查和Bayley婴儿发育量表II评估，以及（3）确定脑代谢的改变，如通过MRSI评估，或脑微结构的改变，如通过DTI评估，与30个月神经发育结果有更强的相关性，如神经运动评分、眼科评估和贝利婴儿发育量表II所评估。

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.