DTI评价高危妊娠早产儿脑发育及与胎儿脐动脉血流频谱的相关性  

DTI evaluation of brain development in high-risk preterm infants and its correlation with fetal umbilical artery blood flow spectrum

作　　者：韩义娜[1] 刘彦超 赵鑫[1] 张小安[1] 刘真真[1] HAN Yi-na;LIU Yan-chao;ZHAO Xin;ZHANG Xiao-an;LIU Zhen-zhen(Department of Radiology,the Third Affiliaied Hospital,of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院医学影像科,河南郑州450052

出　　处：《中国临床医学影像杂志》2021年第2期77-82,共6页Journal of China Clinic Medical Imaging

基　　金：国家自然科学基金资助项目(编号80870983)。

摘　　要：目的:探讨扩散张量成像技术(Diffusion tensor imaging,DTI)评价高危妊娠早产儿脑发育的价值及与脐动脉(Umbilical artery,UA)血流频谱的相关性。方法:选择本院2015年7月—2020年3月的42例子痫前期(Preeclampsia,PE)、26例妊娠期糖尿病(Gestational diabetes mellitus,GDM)及16例子痫前期合并糖尿病(PE+GDM)孕妇分娩的早产儿为观察组,无合并症孕妇分娩早产儿52例为对照组。回顾性分析两组围产期基本资料;对两组头颅感兴趣区各向异性分数值(FA)进行单因素方差分析,并与胎儿期UA-S/D及UA-PI值进行相关性分析。结果:PE组及PE+GDM组MRI上发现异常信号及皮质脊髓束稍稀疏的病例数多于GDM组及对照组(P<0.012);观察组内囊后肢及额叶白质的FA值均低于对照组;UA-S/D值及UA-PI值调整其他因素前后均与内囊后肢FA值呈明显的负相关;张路指数、出生孕周、扩散张量成像检查时日龄与FA均值呈一定的相关性。结论:高危妊娠可能致早产儿脑发育落后,胎儿脐动脉血流频谱与早产儿内囊后肢的FA值具有一定相关性。Objective:To investigate the value of DTI in evaluating brain development of preterm infants at high risk and its correlation with the umbilical artery(UA)blood flow spectrum.Methods:From July 2015 to March 2020,42 cases of preeclampsia(PE),26 cases of gestational diabetes mellitus(GDM)and 16 cases of PE pregnant women with GDM(PE+GDM)were selected as the observation group,and 52 cases of premature babies born without complications were compared group.Retrospective analysis of the basic data of the perinatal period in the two groups.One-way analysis of variance of the anisotropy score(FA)values of the ROI of the two groups.The correlation between FA value and UA-S/D and UA-PI value in fetal period was analyzed.Results:PE and PE+GDM groups found more abnormal signals and slightly less cortical spinal cord MRI cases than GDM and control groups(P<0.012).The FA values of the hindlimb and frontal white matter in the observation group were lower than those in the control group.The other factors before and after the UA-PI value adjustment were significantly negatively correlated with the FA value of the hindlimb of the inner capsule.The Zhang Lu index,gestational age at birth and day age at DTI examination were correlated with the FA mean value.Conclusion:High-risk pregnancies may lead to backward brain development in premature infants,and fetal UA blood flow spectrum is correlated with FA values of posterior limbs of the internal sac in premature infants to some extent.

关 键 词：胎儿发育 婴儿 早产 磁共振成像 

分 类 号：R714.51[医药卫生—妇产科学] R445.2[医药卫生—临床医学]