未成熟儿与足月新生儿脑发育的对照分析

Comparative analysis of brain development between premature infants and full-term neonates

目的：探讨未成熟儿新生儿期与纠正胎龄足月时脑发育变化及其MRI影像学特点，并与足月新生儿进行对照。方法：对30例29—36周未成熟儿，在新生儿期及纠正胎龄40周行MRI检查，并与生后7天内的足月新生儿进行对照。结果：未成熟儿脑白质T1Flair序列低信号，T2WI序列高信号，T2Flair序列等信号，DWI无异常信号；29—36周胎龄未成熟儿延髓、桥脑背侧、小脑脚、1／2中脑背侧、内囊后肢、丘脑腹外侧核处髓鞘在T1Flair序列清晰可见，T1Flair序列高信号，T2WI序列低信号；35周以上未成熟儿脑回成熟度完全接近纠正足月胎龄期，但皮质薄；脑神经垂体与腺垂体刚出生时T1Flair序列为极高信号，纠正胎龄足月期变成等信号，高度由2mm发育至3mm；胼胝体在未成熟期与纠正胎龄足月期均为等信号（与脑灰质比较），厚度由1mm发育至2～3mm。结论：MRI对未成熟儿脑部髓鞘发育及结构显示清楚，未成熟儿纠正足月胎龄期与足月新生儿脑发育无明显差异。

Objective： To explore the changes of brain development and MRI imaging features between premature infants and full - term neonates. Methods i 30 premature infants of 29 - 36 weeks underwent MRI examination in neonatal period and the fortieth weeks after correcting gestational age, then the results were compared to full - term neonates within 7 days after birth. Results： T2 Flair low signal, T2WI high signal, T2 Flair isointense signal and DWI of no abnormal signal were detected in brain white matter of premature infants; clear T1 Flair sequence, Tl Flair high Signal and T2WI low signal were detected in medulla oblongata, dorsal pons, cerebellum feet, 1/2 of dorsal brain, internal capsule hind legs, myelin sheath of ventrolateral thalamus nuclei of premature infants of 29 - 36 weeks ; the maturity of gyrus in premature infants over 35 weeks was on the verge of infants after correcting gestational age, but the cortex was thinner; T1 Flair very high signal was detected in neurohypophysis and adenohypophysis in premature infants, but in infants after correcting gestational age, Tl Flair isointcnse signal was detected, the height of pituitary developed from 2 mm to 3 mm; isointense signal of corpus eallosum was detected in premature infants and infants after correcting gestational age, the thickness developed from 1 mm to 2 -3 ram. Conclusion： MRI imaging can demonstrate the development and structures of brain myelin sheath clearly, there is no significant difference between premature infants after correcting gestational age and full -term neonates.