早产儿与足月儿胼胝体面积的对比研究

A contrastive study of corpus callosum area in very preterm and full-term infants

摘要:

目的 比较足月儿与发育至同龄的极低出生体重（VLBW）早产儿胼胝体及其分区面积的差异，以期为早产儿胼胝体宫外生长发育监测提供参考。方法 24例胎龄为39周的足月儿于出生当日、30例VLBW早产儿于纠正胎龄39周时分别接受颅脑高场MRI检查，扫描序列为T1WI、T2WI和DWI，选择T1WI正中矢状位图像，共得到49例合格的颅脑MRI图像，其中足月儿组21例，VLBW早产儿组28例；由两名影像学医师于不同时间分别勾画两次胼胝体及大脑，使用MATLAB R2010a中的图像处理函数对所勾画的图像进行测量，得到胼胝体及其6个分区面积。结果 VLBW早产儿组整个胼胝体及其6个分区中的前中体部、后中体部、峡部和压部面积均小于与之同龄的足月儿组（均P<0.05），但膝部和前体部面积在两组间差异均无统计学意义（均P>0.05）。结论 早产儿胼胝体后部区域的发育可能更容易受到病理因素的影响。

Abstract:

Objective To compare the differences between full-term and VLBW premature infants at term equivalent for the whole and sub-regional corpus callosum areas in order to provide reference for monitoring the extrauterine development of corpus callosum in VLBW premature infants. Methods Brain MR image data of 24 term infants with a gestational age of 39 weeks were collected within 24 hours after birth. Brain MR image of 30 VLBW neonates at 39 weeks' gestational age equivalent were successfully obtained. Routine T1WI, T2WI and DWI were applied. T1-weighted images on the mid-sagittal slice were selected, analyzed and measured. Forty-nine eligible MR images of them were chosen, 21 cases from the full-term infant group and 28 cases from the premature infant group. Corpus callosum and brain MR images were then sketched by two radiographic doctors. All data were analyzed by the Image Processing Function of MATLAB R2010a, and the whole corpus callosum and six sub-regions were obtained. Results The whole corpus callosum, anterior mid-body, posterior mid-body, isthmus and splenium area in the premature infant group were smaller than those in the full-term infant group (P<0.05), but the differences of Genu and rostral body area between the two groups was not statistically significant (P>0.05). Conclusions The areas of the whole corpus callosum, anterior mid-body, posterior mid-body, isthmus and splenium in VLBW preterm infants at term are reduced, suggesting that the posterior end of the corpus callosum is probably most vulnerable to insults following pathogenic factors.