不同胎龄新生儿脑代谢物及脑内不同部位体积的研究  

Brain metabolites and regional brain volumes of newborns with different gestational ages

作　　者：肖钢明[1] 刘丽芳[1] 姜梅[2] 沈比先[2] 谢井文[2] 李晓东[1] 田青[1] 

机构地区：[1]广东医学院附属南山医院新生儿科,深圳518052 [2]广东医学院附属南山医院放射科,深圳518052

出　　处：《中国新生儿科杂志》2015年第4期255-258,共4页Chinese Journal of Neonatology

基　　金：深圳市科技计划项目(201103304)

摘　　要：目的通过氢质子磁共振波谱（3H MRS）检测不同胎龄新生儿脑代谢物,并应用软件测量磁共振成像（MRI）脑内不同部位体积,探讨不同胎龄新生儿脑代谢物和脑不同部位体积的变化和意义。方法选取2012年8月至2014年9月我院新生儿科收治的无神经系统病变、感染、缺氧、代谢异常等问题的患儿,生后4-7天进行头颅MRI检查,并采用MATLAB和ITKSNAP软件计算大脑、小脑、脑脊液和颅内腔体积,3H MRS测量右侧额叶的代谢物N-乙酰天门冬氨酸（NAA）、胆碱类化合物（Cho）和肌酸类（Cr）波峰下面积,计算NAA/Cr、Cho/Cr和NAA/Cho比值。结果共纳入88例新生儿,胎龄32-33周21例,34-36周26例,37-38周21例,39-41周20例,各组性别和日龄差异均无统计学意义（P〉0.05）。32-33周组、34-36周组、37-38周组和39-41周组新生儿NAA/Cr（0.58±0.10,0.75±0.15,0.76±0.15,0.76±0.11）、NAA/Cho（0.41±0.09,0.47±0.11,0.49±0.10,0.47±0.06）、大脑体积（× 10^4mm^3）（28.2±1.9,29.6±1.6,30.9±2.2,31.7±2.9）、小脑体积（× 10^4mm^3）（1.79±0.11,1.87±0.15,1.94±0.16,2.01±0.26）与颅内腔体积（× 10^4mm^3）（31.7±2.0,33.1±1.7,34.5±2.2,35.3±3.1）组间差异均有统计学意义（P〈0.05）,32-33周组NAA/Cr和NAA/Cho均低于其余3组（P〈0.05）,34-36周组、37-38周组和39-41周组之间差异无统计学意义（P〉0.05）;34-36周组、37-38周组和39-41周组与32-33周组小脑体积差异均有统计学意义（P〈0.05）,39-41周组与34-36周组大脑体积和颅内腔体积差异均有统计学意义（P〈0.05）,37-38周组与34-36周组大脑体积差异有统计学意义（P〈0.05）,37-38周组与39-41周组各部位体积差异均无统计学意义（P〉0.05）。各组Cho/Cr和脑脊液体积差异均无统计学意义（P〉0.05）。NAA/Cr、NAA/Cho、大脑体积、小脑体积和颅内腔体积与体重和胎龄均成正相关,Cho/Cr和脑脊液体积与体重和胎龄无明显相关。结论胎儿脑形Objective To detect the brain metabolites and to measure regional brain volumes of newborns with different gestational ages by3 H magnetic resonance spectroscopy（3H MRS） and MRI（ magnetic resonance imaging） plus software,respectively. To investigate the relationship between gestational age（ GA） and brain metabolites / regional brain volumes of newborns. Methods Infants without nervous system lesions,infection,hypoxia,metabolic abnormalities etc. were collected from those admitted to department of neonatology of our hospital from 2012 August to 2014 September. The cerebral MRI examination were taken done 4- 7 days after birth. The volume of cerebrum,cerebellar,cerebrospinal fluid and cranial cavity were calculated by MATLAB and ITKSNAP software. The peak area of the N-acetyl aspartic（ NAA）,choline compounds（ Cho） and creatine compounds（ Cr）- metabolites of right frontal lobe-were measured by3 H MRS,the ratio of Cho / Cr and NAA / Cho,NAA / Cr were also calculated. Results Total of 88 infants were enrolled,with 21 cases of GA 32- 33 weeks,26 cases of GA 34- 36 weeks,21 cases of GA 37- 38 weeks,and 20 cases of GA 39- 41 weeks. Variation of sex ratio and age of days were not significantly different between each GA group（ P〉 0. 05）. The NAA / Cr of each GA group was 0. 58 ± 0. 10,0. 75 ± 0. 15,0. 76 ± 0. 15,0. 76 ± 0. 11,respectively. The NAA /Cho of each GA group was 0. 41 ± 0. 09,0. 47 ± 0. 11,0. 49 ± 0. 10,0. 47 ± 0. 06,respectively. The volume of cerebrum（ × 10^4mm^3） of each GA group was 28. 2 ± 1. 9,29. 6 ± 1. 6,30. 9 ± 2. 2,31. 7 ±2. 9,respectively. The volume of cerebellum（ × 10^4mm^3） of each GA group was 1. 79 ± 0. 11,1. 87 ±0. 15,1. 94 ± 0. 16,2. 01 ± 0. 26,respectively. The volume of cranial cavity（ × 10^4mm^3） of each GA group was 31. 7 ± 2. 0,33. 1 ± 1. 7,34. 5 ± 2. 2,35. 3 ± 3. 1,respectively. The NAA / Cr,NAA / Cho and volume of cerebrum,cerebellar,cranial cavity were all significantly different among GA groups. The NAA / Cr and NAA / Cho

关 键 词：磁共振波谱 磁共振成像 脑代谢物 脑体积 婴儿 新生 

分 类 号：R722.1[医药卫生—儿科]