| 杨铭雯,张琳,蓝佐珍,彭婷,林英,刘俊刚.基于3D MR T1结构像观察早产儿脑结构改变并分析其临床危险因素[J].中国医学影像技术,2025,41(10):1628~1632 |
| 基于3D MR T1结构像观察早产儿脑结构改变并分析其临床危险因素 |
| Observation on brain structural changes in preterm infants and analysis of clinical risk factors based on 3D T1 structural MRI |
| 投稿时间：2025-04-25 修订日期：2025-09-29 |
| DOI：10.13929/j.issn.1003-3289.2025.10.003 |
| 中文关键词: 婴儿,早产 脑 磁共振成像 |
| 英文关键词:infant, premature brain magnetic resonance imaging |
| 基金项目:厦门市自然科学基金(3502Z202374061)。 |
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| 中文摘要: |
| 目的 基于3D MR T1结构像观察早产儿脑结构改变并分析其临床危险因素。方法 回顾性分析82例早产儿(早产组)和50例足月儿(足月组)脑部3D T1结构像;比较组间皮层形态学差异,包括皮层厚度、表面积、脑沟深度及脑回曲率;以Spearman偏相关分析评估皮层结构变化与围产期临床变量间的相关性。结果 相比足月组,早产组右侧额中回尾侧皮层厚度增加,左侧顶下小叶、左侧楔前叶、双侧缘上回皮层表面积缩小,右侧颞上回、右侧枕外侧回、左侧顶下小叶、左侧海马旁回皮层曲率降低(FDR校正P均＜0.05);组间脑沟深度差异均无统计学意义(P均＞0.05)。早产儿双侧缘上回皮层表面积与孕妇妊娠期糖尿病呈低度-弱负相关(rs=－0.327、－0.267,P均＜0.05),左侧海马旁回皮层曲率与后者呈弱正相关(rs=0.221,P=0.045);早产儿左侧顶下小叶、左侧楔前叶、左侧缘上回及右侧缘上回皮层表面积均与孕妇妊娠期感染呈弱负相关(rs=－0.284~－0.224,P均＜0.05),右侧额中回尾侧皮层厚度及右侧缘上回皮层表面积均与胎膜早破呈低度负相关(rs=－0.311、－0.301,P均＜0.05)。结论 3D MR T1结构像有助于发现早产儿脑皮层形态异常;孕妇罹患妊娠期糖尿病、妊娠期感染及胎膜早破可能是新生儿脑结构异常的危险因素。 |
| 英文摘要: |
| Objective To observe brain structural changes in preterm infants and to analyze associated clinical risk factors based on 3D T1 structural MRI. Methods Brain 3D T1 structural MRI data of 82 preterm infants (preterm group) and 50 term infants (term group) were analyzed. Cortical morphology, including cortical thickness, surface area, sulcal depth and gyrification index were compared between groups. Spearman partial correlation analysis was used to explore the correlations of cortical structural changes and perinatal clinical variables. Results Compared with those in term group, increased cortical thickness of the right caudal middle frontal gyrus, reduced surface area of the left inferior parietal lobule, left precuneus and bilateral supramarginal gyrus, as well as decreased gyrification index in the right superior temporal gyrus, right lateral occipital gyrus, left inferior parietal lobule and left parahippocampal gyrus were observed in preterm group (all FDR corrected P＜0.05). No significant difference of sulcal depth was found between groups (all P＞0.05). Cortical surface area in bilateral supramarginal gyrus of preterm infant lowly-weakly negatively (rs=－0.327, －0.267, both P＜0.05) correlated, while the gyrification index in left parahippocampal gyrus of preterm infant weakly and positively (rs=0.221, P=0.045) correlated with maternal gestational diabetes mellitus. The surface area of left inferior parietal lobule, left precuneus, left supramarginal gyrus and right supramarginal gyrus in preterm infant weakly and negatively correlated with maternal infection during pregnancy (rs=－0.284—－0.224, all P＜0.05). Meanwhile, cortical thickness of the right caudal middle frontal gyrus and surface area of the right supramarginal gyrus in preterm infant lowly and negatively correlated with premature rupture of membranes (rs=－0.311,－0.301, both P＜0.05). Conclusion 3D T1 structural MRI was useful for detecting abnormal cortical morphology of preterm infants. Maternal gestational diabetes, infection during pregnancy and premature rupture of membranes might be risk factors for abnormal brain structure in newborns. |
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