摘要
目的应用动脉自旋标记(arterial spin labeling,ASL)技术探究脑白质损伤(white matter injury,WMI)与早产儿脑灌注的关系。方法回顾性纳入2022年6月—2024年6月于郑州大学第三附属医院住院、胎龄<34周的293例早产儿为研究对象。患儿在病情稳定后完善头颅磁共振成像(magnetic resonance imaging,MRI)和ASL检查。根据头颅MRI结果分为WMI组(66例)和非WMI组(227例),比较两组早产儿脑灌注情况,分析WMI与脑灌注的相关性。结果WMI组患儿合并轻度脑室内出血的比例高于非WMI组(P<0.05);WMI组早产儿双侧额叶、颞叶、顶叶、枕叶、基底节、丘脑的感兴趣区脑灌注量低于非WMI组(P<0.05)。在控制了胎龄、ASL检查时校正胎龄、轻度脑室内出血因素后,WMI与局部脑灌注量降低仍显著相关(P<0.05)。结论早产儿WMI与大脑局部脑区低灌注相关,应用ASL技术揭示的脑灌注异常可为探索WMI提供新的方向。
Objective To explore the relationship between white matter injury(WMI)and cerebral perfusion in preterm infants using arterial spin labeling(ASL).Methods A total of 293 preterm infants(gestational age<34 weeks)hospitalized at the Third Affiliated Hospital of Zhengzhou University between June 2022 and June 2024 were included.After achieving clinical stability,the infants underwent brain magnetic resonance imaging(MRI)and ASL.Based on MRI findings,infants were classified into WMI(n=66)and non-WMI(n=227)groups.Cerebral perfusion parameters were compared between groups,and the association between WMI and perfusion alterations was evaluated.Results The WMI group showed a higher incidence of mild intraventricular hemorrhage(IVH)than the non-WMI group(P<0.05).Significantly lower cerebral perfusion was observed in the WMI group across bilateral frontal,temporal,parietal,and occipital lobes,as well as the basal ganglia and thalamus(P<0.05).After adjusting for gestational age,corrected gestational age at ASL scan,and mild IVH,WMI remained significantly associated with reduced regional perfusion(P<0.05).Conclusions WMI in preterm infants correlates with localized cerebral hypoperfusion.ASL-detected perfusion abnormalities may provide novel insights into WMI pathogenesis.
作者
孔祥博
秦璠玥
段稳丽
陆林
郭笑婵
薛艳然
洪银钢
徐发林
KONG Xiang-Bo;QIN Fan-Yue;DUAN Wen-Li;LU Lin;GUO Xiao-Chan;XUE Yan-Ran;HONG Yin-Gang;XU Fa-Lin(Department of Neonatology,Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中国当代儿科杂志》
北大核心
2025年第6期661-667,共7页
Chinese Journal of Contemporary Pediatrics
关键词
动脉自旋标记
脑白质损伤
脑灌注
感兴趣区
早产儿
Arterial spin labeling
White matter injury
Cerebral perfusion
Region of interest
Preterm infant
