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

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。简介：极低出生体重（VLBW）早产儿神经系统异常的风险增加，包括认知功能差，学业成绩下降，视力残疾，听力障碍和脑瘫。1H磁共振波谱（MRS），定量测量特定的代谢物在大脑的各个区域，已被证明可以预测足月窒息新生儿的神经发育结果。本回顾性研究的目的是评价近足月1H MRS在预测VLBW早产儿18-24个月神经发育结局中的作用。方法和讨论：患者队列由36名符合入选标准的婴儿组成，扫描时间为2001年9月至2003年9月：出生体重？1510克，胎龄？32周，扫描年龄为月经后35-43周。MRI/MRS在1.5T扫描机上进行。在两个感兴趣的区域中分析代谢物光谱：1）合并的左右丘脑和基底神经节，以及2）左右皮质。对胆碱（Ch）、肌酸和磷酸肌酸（Cr）以及N-乙酰天冬氨酸（NAA）峰进行积分，并计算Ch/Cr、NAA/Cr和NAA/Ch的比值。在18-24个月时，通过贝利婴儿发育量表II的精神发育指数（MDI）和精神发育指数（PDI）对患者进行评估。根据他们的MDI和PDI评分，患者被分为两个结果组的每个指标，正常（？85)异常（<85）。 鸣谢：儿科研究学会，卢卡斯基金会，NIH RR 09784，CA 48269

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