CAJ | 학술논문

目的探究早产儿深部脑白质表观弥散系数(ADC)及分数各向异性值(FA)的正常值及其应用.方法 2010年10月至2013年12月在江苏省人民医院新生儿病区收集55例早产儿、15例足月儿,分3组:纠正胎龄(CA) ＜37周组,13例;CA足月组,42例;足月儿组,15例.分别在CA＜ 37周、CA足月及新生儿期进行MRI扫描,采集胼胝体膝部、压部及左右内囊前后肢的ADC及FA值.结果 1.ADC值:在胼胝体及内囊各区域,CA＜ 37周组ADC值高于CA足月组及足月儿组.在膝部、压部、右侧内囊前、后肢及左侧内囊前、后肢,3组ADC值相比较,差异均有统计学意义(F=5.559、5.775、21.948、19.462、30.586、15.452,P均＜0.01).CA＜ 37周组与CA足月组同区域比较,除胼胝体外,其他区域ADC值的差异均有统计学意义(P均＜0.05).CA＜ 37周组与足月儿组同区域比较,ADC值的差异均有统计学意义(P均＜0.05).2.FA值:在胼胝体及内囊各区域,CA＜ 37周组FA值低于CA足月组及足月儿组.在膝部、压部、右侧内囊前、后肢及左侧内囊前、后肢,3组FA值相比较,差异均有统计学意义(F=9.835、7.500、4.811、11.430、8.674、12.666,P均＜0.01).CA足月组及足月儿组FA值与CA＜ 37周组相同部位FA值比较,差异均有统计学意义(P均＜0.05);在胼胝体膝部,CA足月组FA值与足月儿组比较,差异有统计学意义(P＜0.05).结论初步获得不同CA早产儿深部白质各区域FA及ADC的参考值;随胎龄的增加,早产儿脑白质FA值增加,ADC值则减少;早产儿髓鞘形成在大多部位可赶上足月儿;早产儿深部白质的FA及ADC值的诊断价值有待进一步的研究.
목적 탐구조산인심부뇌백질표관미산계수(ADC)급분수각향이성치(FA)적정상치급기응용.방법 2010년10월지2013년12월재강소성인민의원신생인병구수집55례조산인、15례족월인,분3조:규정태령(CA) ＜37주조,13례;CA족월조,42례;족월인조,15례.분별재CA＜ 37주、CA족월급신생인기진행MRI소묘,채집변지체슬부、압부급좌우내낭전후지적ADC급FA치.결과 1.ADC치:재변지체급내낭각구역,CA＜ 37주조ADC치고우CA족월조급족월인조.재슬부、압부、우측내낭전、후지급좌측내낭전、후지,3조ADC치상비교,차이균유통계학의의(F=5.559、5.775、21.948、19.462、30.586、15.452,P균＜0.01).CA＜ 37주조여CA족월조동구역비교,제변지체외,기타구역ADC치적차이균유통계학의의(P균＜0.05).CA＜ 37주조여족월인조동구역비교,ADC치적차이균유통계학의의(P균＜0.05).2.FA치:재변지체급내낭각구역,CA＜ 37주조FA치저우CA족월조급족월인조.재슬부、압부、우측내낭전、후지급좌측내낭전、후지,3조FA치상비교,차이균유통계학의의(F=9.835、7.500、4.811、11.430、8.674、12.666,P균＜0.01).CA족월조급족월인조FA치여CA＜ 37주조상동부위FA치비교,차이균유통계학의의(P균＜0.05);재변지체슬부,CA족월조FA치여족월인조비교,차이유통계학의의(P＜0.05).결론 초보획득불동CA조산인심부백질각구역FA급ADC적삼고치;수태령적증가,조산인뇌백질FA치증가,ADC치칙감소;조산인수초형성재대다부위가간상족월인;조산인심부백질적FA급ADC치적진단개치유대진일보적연구.
Objective To study the baseline level of fraction anisotropy (FA) and the normal value of apparent diffusion coefficient (ADC) in deep white matter of preterm and its application.Methods From Oct.2010 to Dec.2013,in Department of Neonatology,Jiangsu Province Hospital,magnetic resonance imaging (MRI) (T1,T2) and diffusion tensor imaging (DTI) were done on 13 preterm infants of less than 37 weeks of corrected gestational age (CA),42 preterm infants of term-matched age,and 15 term infants.ADC and FA were measured in genu and splenium of corpus callosum (CC),anterior limb and posterior limb of internal capsule (IC).Results 1.The ADC values in genu,splenium,anterior limb of right IC,posterior limb of right IC,anterior limb of left IC,posterior limb of left IC in CA ＜ 37 weeks infants were higher than those in term-matched infants and in term infants.The ADC values in the 6 regions in term-matched infants and in term infants were significantly different with those in CA ＜ 37 weeks infant(F =5.559,5.775,21.948,19.462,30.586,15.452,all P ＜ 0.01).The differences of ADC values between CA ＜ 37 weeks infants and term-matched infants,between CA ＜37 weeks infants and term infants were significant(all P ＜0.05),except that in CC between CA ＜ 37 weeks infants and term-matched infants.2 The FA values in genu,splenium,anterior limb of right IC,posterior limb of right IC,anterior limb of left IC,posterior limb of left IC in CA ＜ 37 weeks infants were lower than those in term-matched infants and in term infants.The FA values in the 6 regions in term-matched infants and in term infants were significantly different from those in CA ＜ 37 weeks infants (F =9.835,7.500,4.811,11.430,8.674,12.666,all P ＜ 0.01).The differences of FA values between CA ＜ 37 weeks infants and term-matched infants (P ＜ 0.05),between CA ＜ 37 weeks infants and term infants were significant (all P ＜ 0.05).Conclusions The baseline values of FA and ADC in different deep white matters were obtained.As corrected gestational age of preterm babies' increased,FA values in brain white matter increased,while ADC values decreased.The myelination in most white matter of preterm infants at matched term can catch up with that of term infants.The diagnostic value of ADC and FA needs to be studied further.