基于磁共振动脉自旋标记成像技术探讨早产儿脑灌注的特点  

The characteristics of cerebral perfusion in preterm infants based on arterial spin labeling magnetic resonance imaging

作　　者：张萌[1] 邢景月 薛倩茹 马徜徉 王彬[1] 徐发林[1] Zhang Meng;Xing Jingyue;Xue Qianru;Ma Changyang;Wang Bin;Xu Falin(Department of Neonatology,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450002,China)

机构地区：[1]郑州大学第三附属医院新生儿科,郑州450002

出　　处：《中华新生儿科杂志（中英文）》2024年第7期407-411,共5页Chinese Journal of Neonatology

基　　金：河南省儿科疾病临床研究中心开放课题(KFKT2021103)。

摘　　要：目的:基于磁共振动脉自旋标记(arterial spin labeling,ASL)成像技术测量脑血流,探讨早产儿脑灌注的特点。方法:采用前瞻性研究,选择2022年6月至2023年6月郑州大学第三附属医院新生儿科胎龄28~32周的单胎极早产儿为研究对象(极早产组),按照1∶1的比例匹配同期住院的胎龄≥37周单胎足月儿为对照(足月组)。极早产组于校正胎龄38~42周、足月组于生后1周内完成头颅磁共振成像及ASL检查,比较两组新生儿ASL相同感兴趣区(额叶、颞叶、顶叶、枕叶、基底节区和丘脑)脑血流的差异。结果:共纳入84例,极早产组42例,足月组42例。极早产组校正胎龄38~42周两侧额叶、颞叶、顶叶和枕叶脑血流值高于足月组,差异有统计学意义(P<0.05)。将出生胎龄、出生体重,完成头颅磁共振成像时的校正胎龄、体重、头围、日龄,以及辅助通气时间等因素纳入多元线性回归分析,结果显示,极早产儿高灌注状态与出生胎龄、机械通气时间相关(P<0.05)。结论:校正胎龄足月时极早产儿部分大脑感兴趣区脑血流值较足月儿高,高脑血流状态可能与极早产儿脑成熟度异常有关。Objective To study the characteristics of cerebral perfusion in premature infants based on cerebral blood flow(CBF)values observed by arterial spin labeling(ASL)magnetic resonance perfusion imaging.Methods From June 2022 to June 2023,singleton very preterm infants with gestational age of 28-32 weeks who were admitted to the Department of Neonatology of the Third Affiliated Hospital of Zhengzhou University were included in this prospective study,and singleton full-term infants with a gestational age of≥37 weeks who were hospitalized during the same period were matched according to 1∶1 as the control group.Brain magnetic resonance imaging and ASL were performed in very preterm infants with a corrected gestational age of 38-42 weeks and full-term infants within 1 week after birth.The difference in cerebral blood flow between two groups of newborns was compared based on ASL in the same areas of interest(frontal,temporal,parietal,occipital,basal ganglia,and thalamus).Results A total of 84 neonates were enrolled,including 42 in the very preterm group and 42 in the term group.Compared with full-term infants,very preterm infants demonstrated higher CBF in the frontal,temporal,parietal,and occipital lobes on the left and right sides at term-equivalent age,with statistical significance(P<0.05).Factors such as gestational age,birth weight,corrected gestational age of completing head MRI,body weight,head circumference and day age,and assisted ventilation time were included in multiple linear regression analysis.The result showed that the status of hyperperfusion in very preterm infants was correlated with gestational age and duration of mechanical ventilation(P<0.05).Conclusions CBF of some brain regions of interest is higher in very preterm infants at term-equivalent age than those in term infants,and high CBF status may be associated with abnormal brain maturity in very preterm infants.

关 键 词：脑血流 磁共振动脉自旋标记成像技术 早产儿 

分 类 号：R722.6[医药卫生—儿科]