妊娠期糖尿病早产儿脑发育的影像学评估  

Imaging evaluation of brain development in preterm infants with gestational diabetes

作　　者：陈艳 张小安[1] 韩义娜[1] 王程程 赵鑫[1] Chen Yan;Zhang Xiaoan;Han Yina;Wang Chengcheng;Zhao Xin(Department of Medical Imaging,the Third Affiliated Hospital of Zhengzhou University,Henan 450051,China)

机构地区：[1]郑州大学第三附属医院医学影像科,450051

出　　处：《实用医技杂志》2020年第8期977-980,共4页Journal of Practical Medical Techniques

基　　金：国家自然科学基金资助项目(80870983)。

摘　　要：目的 研究多模态磁共振如何评估母亲妊娠期糖尿病对早产儿脑发育和脑损伤的影响.方法 选取2018年4月至2019年8月在郑州大学第三附属医院新生儿重症监护室收治的进行磁共振检查的早产儿61例,28例妊娠期糖尿病孕妇分娩的早产儿作为观察组,另33例无高危围生因素孕妇分娩的早产儿作为对照组,应用3.0T磁共振对所有观察对象进行常规磁共振成像(MRI)和弥散张量成像(DTI)扫描,分析2组围生期资料、颅脑损伤情况和脑白质微结构.对妊娠期糖尿病组早产儿出生时Apgar评分与额叶白质各向异性分数(FA)值进行相关性分析.结果 早产儿脑损伤以脑白质损伤和脑室周围软化为主;2组早产儿的内囊后肢、胼胝体压部、丘脑、大脑脚、枕叶白质FA值平均值差异均有统计学意义(P<0.05),妊娠期糖尿病组早产儿出生后1 min、5 min Apgar评分与枕叶白质FA值无明显相关性(r=-0.061,P>0.05;r=-0.149,P>0.05).结论 母亲妊娠期糖尿病疾病可能导致早产儿脑发育落后,对妊娠期糖尿病早产儿脑发育进行早期诊断和干预能有效提高早产儿生存质量和远期预后.Objective To study how multimodal magnetic resonance can evaluate the effects of maternal gestational diabetes on brain development and brain damage in preterm infants.Methods From April 2018 to August 2019,61 premature babies who underwent magnetic resonance examination in the neonatal intensive care unit of the Third Affiliated Hospital of Zhengzhou University in Henan were selected,and 28 premature babies who were delivered by pregnant women with gestational diabetes were used as observation group Another 33 premature babies born to pregnant women without high-risk perinatal factors were used as a control group.All subjects were subjected to conventional magnetic resonance imaging(MRI)and diffusion tensor imaging(DTI)scans using 3.0T magnetic resonance imaging.The perinatal data and craniocerebral injury were analyzed in both groups.Condition and white matter microstructure.Correlation analysis between Apgar score at birth and FA value of frontal white matter in gestational diabetes group.Results The brain injury of premature infants was mainly white matter injury and periventricular softening.The mean values of FA valuesof inner capsule hind limbs,corpus callosum pressure,thalamus,cerebral feet,and occipital lobe white matter were significantly different between the two groups(all P<0.05).There was no significant correlation between Apgar score and FA value of occipital white matter in preterm infants with gestational diabetes mellitus(r=-0.061,P>0.05;r=-0.149,P>0.05).Conclusion Maternal gestational diabetes mellitus may lead to retarded brain development in preterm infants.Farly diagnosis and intervention of brain development in preterm infants with gestational diabetes mellitus can effectively improve the quality of life and long-term prognosis of preterm infants.

关 键 词：早产儿 妊娠期糖尿病 多模态磁共振 APGAR评分 

分 类 号：R714.256[医药卫生—妇产科学] R722.6[医药卫生—临床医学]