3D-pCASL在评估妊娠期高血压对早产儿脑发育影响中的价值  

3D-pCASL in the developmental brain abnormalities of preterm infants born to hypertensive mothers during pregnancy

作　　者：李思柯 程美英[1,2,3] 张灵洁 鲁钰 冯占起 刘世鹏 冯刘娟 周梁 赵鑫 LI Sike;CHENG Meiying;ZHANG Lingjie;LU Yu;FENG Zhanqi;LIU Shipeng;FENG Liujuan;ZHOU Liang;ZHAO Xin(Department of Medical Imaging,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Henan International Joint Laboratory of Neuroimaging,Zhengzhou 450052,China;Henan Provincial Key Laboratory of Pediatric Neuroimaging Medicine,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院医学影像科,郑州450052 [2]河南省神经医学影像国际联合实验室,郑州450052 [3]河南省小儿神经影像医学重点实验室,郑州450052

出　　处：《磁共振成像》2025年第2期7-13,共7页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金项目(编号:82472046)。

摘　　要：目的应用三维准连续动脉自旋标记(three-dimensional pseudo-continuous arterial spin labeling,3D-pCASL)成像技术定量评估妊娠期高血压孕妇分娩的早产儿脑血流量(cerebral blood flow,CBF)值,并深入探讨CBF值与早产儿炎症因子水平及新生儿神经行为测定(Neonatal Behavioral Neurological Assessment,NBNA)评分之间的潜在关联。材料与方法本研究前瞻性分析2023年7月至2024年6月于我院就诊的80例早产儿,依据其母亲是否患有妊娠期高血压分为病例组(40例)和对照组(40例)。两组早产儿均行常规MRI及3D-pCASL序列扫描,组间比较两组早产儿各脑区CBF值,并分析CBF值与炎症因子和NBNA评分的相关性。结果母亲患有妊娠期高血压的早产儿多个脑区CBF值和炎症因子水平均显著高于对照组(P<0.05),而NBNA评分则低于对照组(P<0.05)。其中左侧额叶、右侧颞叶、左侧顶叶、双侧基底节区及丘脑的CBF值与降钙素原呈现一定的正相关(r=0.399、0.469、0.482、0.535、0.606、0.692、0.689,P<0.05),双侧基底节区与丘脑的CBF值与NBNA评分呈负相关(r=−0.395、−0.429、−0.414、−0.438,P<0.05)。结论3D-pCASL技术可无创评估妊娠期高血压孕妇分娩的早产儿脑CBF值,CBF值升高可能与其预后不良有关,这将有助于早产儿脑发育不良的早期诊断及干预治疗。Objective:To quantitatively assess the cerebral blood flow(CBF)values of preterm infants delivered by hypertensive pregnant women during pregnancy using three-dimensional pseudo-continuous arterial spin labeling(3D-pCASL)imaging,and to investigate the potential association between CBF and inflammatory factor levels and Neonatal Behavioral Neurological Assessment(NBNA)scores in preterm infants.Materials and Methods:The present study prospectively analyzed 80 preterm infants attending our hospital from July 2023 to June 2024,who were divided into a case group(40 cases)and a control group(40 cases)based on whether their mothers suffered from gestational hypertension or not.Conventional MRI and 3D-pCASL sequence scans were performed in both groups,and the CBF values of each brain region were compared between the two groups.The correlation between the CBF values and inflammatory factors and NBNA scores was analyzed.Results:CBF values and inflammatory factor levels in several brain regions of preterm infants born to hypertensive mothers during pregnancy were significantly higher than those of the control group(P<0.05),whereas NBNA scores were lower than those of the control group(P<0.05).CBF values in the left frontal lobe,right temporal lobe,left parietal lobe,bilateral basal ganglia regions and thalamus showed some positive correlation with calcitoninogen(r=0.399,0.469,0.482,0.535,0.606,0.692,0.689,P<0.05),and CBF values in the bilateral basal ganglia regions and thalamus showed a negative correlation with NBNA scores(r=−0.395,−0.429,−0.414,−0.438,P<0.05).Conclusions:The 3D-pCASL technique can non-invasively assess the CBF values of preterm infants with gestational hypertension in mothers,and elevated CBF values may be associated with poor prognosis of preterm infants with gestational hypertension in mothers,which will help in early diagnosis of brain dysplasia in their preterm infants and interventional treatment.

关 键 词：早产儿 脑发育 妊娠期高血压 动脉自旋标记成像 磁共振成像 炎症因子 新生儿神经行为测定评分 

分 类 号：R445.2[医药卫生—影像医学与核医学] R714.246[医药卫生—诊断学] R722.6[医药卫生—临床医学]