CAJ | 학술논문

目的通过对不同孕周的正常胎脑不同区域ADC值进行测量,探讨其评价正常胎儿脑发育的可行性.方法对40例孕周为24～41周的正常胎脑进行DWI扫描,b值为0和600 s/mm2,通过后处理软件测量胎儿颅脑额叶白质、基底节区、丘脑、枕叶白质以及小脑的ADC值,然后使用重复测量方差分析及一元线性回归对不同区域ADC值与随孕周变化的关系进行分析.结果 40名正常胎脑的整体额叶白质、基底节区、丘脑、枕叶白质及小脑半球的平均ADC值分别为(1 800±214)×10-6、(1 400±100) ×10-6、(1 300±126) ×10-6、(1 700±133)×10-6及(1 400±155)×10-6mm2/s,差异具有统计学意义(F=80.813,P＜0.01).两两比较显示,除基底节区与丘脑和小脑半球的平均ADC值差异没有统计学意义外,其他两两差异均具有统计学意义.随着孕周的增加,基底节区、丘脑、枕叶白质以及小脑半球的ADC呈下降的趋势,其与孕周具有负相关(Pearson相关系数分别为-0.568、-0.716、-0.830和-0.700,P值均＜0.01).枕叶白质ADC值随孕周增加下降最快,小脑及丘脑次之,基底节区最慢;额叶白质的ADC值与孕周没有相关性(P＞0.05).结论胎脑不同区域ADC值具有特异性,并且ADC值与孕周的发展变化具有相关性,可以作为定量评价正常颅脑发育以及早期诊断胎儿颅脑病变的特征性参数.
목적 통과대불동잉주적정상태뇌불동구역ADC치진행측량,탐토기평개정상태인뇌발육적가행성.방법 대40례잉주위24～41주적정상태뇌진행DWI소묘,b치위0화600 s/mm2,통과후처리연건측량태인로뇌액협백질、기저절구、구뇌、침협백질이급소뇌적ADC치,연후사용중복측량방차분석급일원선성회귀대불동구역ADC치여수잉주변화적관계진행분석.결과 40명정상태뇌적정체액협백질、기저절구、구뇌、침협백질급소뇌반구적평균ADC치분별위(1 800±214)×10-6、(1 400±100) ×10-6、(1 300±126) ×10-6、(1 700±133)×10-6급(1 400±155)×10-6mm2/s,차이구유통계학의의(F=80.813,P＜0.01).량량비교현시,제기저절구여구뇌화소뇌반구적평균ADC치차이몰유통계학의의외,기타량량차이균구유통계학의의.수착잉주적증가,기저절구、구뇌、침협백질이급소뇌반구적ADC정하강적추세,기여잉주구유부상관(Pearson상관계수분별위-0.568、-0.716、-0.830화-0.700,P치균＜0.01).침협백질ADC치수잉주증가하강최쾌,소뇌급구뇌차지,기저절구최만;액협백질적ADC치여잉주몰유상관성(P＞0.05).결론 태뇌불동구역ADC치구유특이성,병차ADC치여잉주적발전변화구유상관성,가이작위정량평개정상로뇌발육이급조기진단태인로뇌병변적특정성삼수.
Objective To investigate the feasibility of ADC values in the evaluation of normal fetal brain development by measuring ADC values changes in specific regions with advancing gestational age.Methods Forty fetuses(gestational age:24 to 41 weeks) with normal brain underwent DWI(b value were 0 and 600 s/mm2).ADC values of the frontal white matter(WM),occipital WM,thalamus,basal ganglia,and cerebellum were measured by post-processing software.The differences among different regions' ADC values were calculated by repeated measurements of ANOVA,and simple linear regression was used to evaluate the relationship between ADC values and gestational age.Results The mean ADC valuesof 40 fetuses were(1 800±214) ×10-6mm2/s in frontal WM,(1 400±100) ×10-6mm2/s in basal ganglia,(1 300±126) ×10-6mm2/s in thalamus,(1 700±133) ×10-6mm2/s in occipital WM and(1 400± 155) × 10-6mm2/s in cerebellum,respectively.There was significant difference in the ADC values among the five regions(F=80.813,P＜0.01).In pair-wise comparison,ADC values of basal ganglia,thalamus and cerebellum had no significant difference; however,others had significant difference between each other.With the increasing gestational age,ADC values of basal ganglia,thalamus,occipital WM and cerebellum decreased,and had significant negative correlations with gestational age(Pearson correlation coefficient were-0.568,-0.716,-0.830 and-0.700,respectively,all P＜0.01).In terms of ADC value,occipital WM declined fastest with gestational age,followed by cerebellum and thalamus,and the slowest was basal ganglia.Frontal ADC values showed no correlation with gestational age(P＞0.05).Conclusions Specific regions of fetal brain have specific ADC values,and ADC values of the region undergo regular change with advancing gestational age.ADC value is a specific quantitative parameter that could help to evaluate normal brain development and early diagnosis of fetal brain lesions.