NBNA评分联合磁共振弥散张量成像在早产儿脑白质发育评价中的作用及相关性分析  

Role of Neonatal Behavioral Neurological Assessment combined with magnetic resonance diffusion tensor imaging in evaluating white matter development in preterm infants

作　　者：张晓丽[1] 刘彦超 夏磊[1] 徐发林[1] ZHANG Xiao-Li;LIU Yan-Chao;XIA Lei;XU Fa-Lin(Department of Neonatology,Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院新生儿科,河南郑州450052 [2]郑州大学第三附属医院影像科,河南郑州450052

出　　处：《中国当代儿科杂志》2021年第9期916-921,共6页Chinese Journal of Contemporary Pediatrics

摘　　要：目的探讨早产儿磁共振弥散张量成像中的各向异性分数(fractional anisotropy,FA)与新生儿行为神经测定(Neonatal Behavioral Neurological Assessment,NBNA)评分的相关性,从影像学角度评价FA在早产儿脑白质发育中的诊断价值。方法前瞻性选择2016年10月至2020年1月生后24 h内入住郑州大学第三附属医院新生儿重症监护室的98例早产儿为研究对象,根据NBNA结果分为异常组(<37分,51例)与正常组(≥37分,47例),采集两组早产儿10个感兴趣区的FA值,比较两组间的差异,并分析FA值及脐动脉血气pH值与NBNA结果的相关性。结果异常组内囊后肢FA值、脐动脉血pH值低于正常组(P<0.05)。内囊后肢FA值、脐动脉血pH与NBNA评分呈正相关(分别rs=0.584、0.604,P<0.001);内囊后肢FA值与脐动脉血pH呈正相关(rs=0.426,P<0.05)。结论早产儿内囊后肢的FA值能定量反映脑白质发育情况,其与NBNA评分具有相关性,二者结合能够更准确、更客观评价早产儿脑白质发育情况。Objective To study the correlation of fractional anisotropy(FA)on magnetic resonance diffusion tensor imaging with Neonatal Behavioral Neurological Assessment(NBNA)score in preterm infants,and to study the role of FA in evaluating white matter development from the perspective of imaging.Methods A prospective study was performed for 98 preterm infants who were admitted to the Neonatal Intensive Care Unit of the Third Affiliated Hospital of Zhengzhou University within 24 hours after birth from October 2016 to January 2020.According to the results of NBNA,they were divided into an abnormal group with 51 infants(NBNA score<37)and a normal group with 47 infants(NBNA score≥37).The FA values of 10 regions of interest were collected and compared between the two groups.The correlations of FA value and umbilical arterial blood gas pH value with the NBNA score were analyzed.Results Compared with the normal group,the abnormal group had significantly lower FA value of the posterior limb of the internal capsule and umbilical arterial blood pH(P<0.05).The FA value of the posterior limb of the internal capsule and umbilical arterial blood pH were positively correlated with the NBNA score(r=0.584 and 0.604 respectively,P<0.001),and the FA value of the posterior limb of the internal capsule was positively correlated with umbilical arterial blood pH(r=0.426,P<0.05).Conclusions The FA value of the posterior limb of the internal capsule can quantitatively reflect white matter development in preterm infants and is correlated with the NBNA score.The combination of the two indices can help to evaluate white matter development in preterm infants more accurately and objectively.

关 键 词：脑白质发育 弥散张量成像 各向异性分数 新生儿行为神经测定 早产儿 

分 类 号：R445.2[医药卫生—影像医学与核医学] R722.6[医药卫生—诊断学]