基于扩散张量成像的新生儿脑白质结构偏侧性研究  

Structural asymmetries in neonatal brain white matter:a diffusion tensor imaging study

作　　者：葛瑶 张玉利 李贤军[1] 李梦轩 刘聪聪 王苗苗[1] 王小玗 杨健[1] Ge Yao;Zhang Yuli;Li Xianjun;Li Mengxuan;Liu Congcong;Wang Miaomiao;Wang Xiaoyu;Yang Jian(Department of Radiology,the First Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710061,China)

机构地区：[1]西安交通大学第一附属医院医学影像科,西安710061

出　　处：《中华放射学杂志》2023年第7期771-776,共6页Chinese Journal of Radiology

基　　金：国家自然科学基金(81971581,81901516,82101815);陕西省重点研发计划(2021SF-092)。

摘　　要：目的应用MRI扩散张量成像(DTI)参量各向异性分数(FA)探讨新生儿脑白质结构偏侧性特征。方法回顾性收集2011年1月至2013年6月西安交通大学第一附属医院头颅MRI表现正常的88例新生儿,日龄1~14(7.7±0.3)d,胎龄31~42(37.5±0.3)周。根据出生胎龄,将新生儿分为早产儿组(37例)和足月儿组(51例)。对DTI图像进行处理,生成FA参量图,采用基于纤维束空间统计(TBSS)方法获得全脑脑白质偏侧性结果。在双侧对称性白质纤维束放置感兴趣区,白质纤维束包括双侧丘脑前辐射、双侧皮质脊髓束内囊后肢段(CST-IC)、双侧皮质脊髓束放射冠段、双侧扣带回海马部(CGH)、双侧下额枕束(IFOF)、双侧下纵束(ILF)、双侧上纵束(SLF)、双侧钩束、双侧上纵束颞部(SLF-temp),测量FA值并计算偏侧性系数(AI)。早产儿组与足月儿组间各纤维束AI的比较采用两独立样本t检验或Mann-Whitney U检验。采用偏相关系数分析新生儿胎龄及出生指标与脑白质纤维束AI的相关性。结果TBSS结果显示,新生儿脑白质左侧偏侧性区域主要分布在皮质脊髓束、外囊、胼胝体膝部,右侧偏侧性区域主要分布在视辐射、胼胝体压部。早产儿组与足月儿组运动(CST-IC)及语言功能(ILF、SLF、SLF-temp)相关纤维束均呈左侧偏侧性。早产儿组与足月儿组CGH均呈右侧偏侧性,AI分别为-0.086±0.114和-0.140±0.108,差异有统计学意义(t=2.27,P=0.026),其余纤维束AI差异均无统计学意义(P>0.05)。胎龄与ILF(r=0.234,P=0.033)、SLF(r=0.259,P=0.018)、SLF-temp(r=0.252,P=0.022)、CST-IC(r=0.235,P=0.033)的AI存在相关性,出生体质量、头围、身长与AI均无明显相关性(P>0.05)。结论出生2周内的新生儿脑白质已存在偏侧性,运动与语言功能相关的纤维束以左侧偏侧性为主。Objective To explore the asymmetry of neonatal brain white matter using fractional anisotropy(FA)parameter generated from diffusion tensor imaging(DTI).Methods From January 2011 to June 2013,88 neonates with normal cranial MRI performance,aged 1-14(7.7±0.3)days and gestational age 31-42(37.5±0.3)weeks,were retrospectively collected from the First Affiliated Hospital of Xi′an Jiaotong University.According to the gestational age at birth,the neonates were divided into preterm group(37 cases)and term group(51 cases).DTI was processed to generate FA parametric maps.Tract-based spatial statistics(TBSS)was used to analyze the asymmetry in neonatal white matter.Regions of interest were placed in bilaterally symmetrical white matter tracts.The white matter tracts included the bilateral anterior thalamic radiation,corticospinal tract-posterior limb of the inner capsule(CST-IC),corticospinal tract-corona radiata,cingulum hippocampus part(CGH),inferior frontal occipital fasciculus(IFOF),inferior longitudinal fasciculus(ILF),superior longitudinal fasciculus(SLF),uncinate fasciculus,superior longitudinal fasciculus temporal part(SLF-temp).The FA value was measured and asymmetry index(AI)was calculated.The independent-sample t test or Mann-Whitney U test was used to compare the AI of each tract between the preterm and term groups.Partial correlation was used to analyze the effects of neonatal gestational age and birth anthropometric measures on the asymmetry of neonate at birth.Results The results of TBSS showed that the left lateralized areas of brain white matter in the neonatal period were mainly located in the corticospinal tract,external capsule and genu of corpus callosum.The right lateralized areas of brain white matter in the neonatal period were mainly located in the optic radiation and splenium of corpus callosum.In both the preterm and term groups,the tracts related to motor(CST-IC)and language function(ILF,SLF,SLF-temp)were left asymmetry.The CGH of the preterm and the term neonates were right asymmetry,and AI

关 键 词：婴儿 新生 脑白质 结构偏侧性 扩散张量成像 

分 类 号：R722.1[医药卫生—儿科]