早产儿与足月儿胼胝体大小及形状的对比研究

Contrastive study on corpus callosum size and shape in preterm and full-term infants

目的比较足月儿与发育至同龄的极低出生体重(very low birth weight,VLBW)早产儿胼胝体面积、偏心率和斜率的差异,为早期评价和改善早产儿脑发育提供参考。方法 55例胎龄为40周的足月儿于出生当日、80例VLBW早产儿于纠正胎龄40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127例合格的颅脑MRI图像,其中足月儿组49例,VLBW早产儿组78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区域,使用MATLAB R2010a中的图像处理函数对所勾画的图像进行测量,计算得到胼胝体面积、前部斜率、后部斜率及偏心率。结果 VLBW早产儿组胼胝体面积和后部斜率均小于足月儿组,前部斜率大于足月儿组,两组间差异有统计学意义(P均<0.05)。VLBW早产儿组胼胝体偏心率小于足月儿组,两组间差异无统计学意义(P>0.05)。结论早产影响胼胝体的发育,VLBW早产儿发育至与足月儿同龄时胼胝体可能较小且较圆。

Objective To compare the difference between full-term infant and very low birth weight(VLBW)premature infant at term equivalent for the area,eccentricity ratio and skew of neonatal corpus callosum and to provide references for early evaluation the development of premature infant brain. Methods Brain MR images of 55full-term infants with gestational age 40 weeks were obtained,which were collected in 24 hafter birth.And brain MR images of 80 VLBW neonates at 40weeks’ gestational age equivalent were successfully obtained.Routine T1 WI,T2WI and DWI were applied.T1-weighted images on the mid-sagittal slice were selected,analyzed and measured.127 eligible MR images of them were chosen,49 cases in the full-term infant group,78 cases in the premature infant group.And then,corpus callosum and brain in the MR images were sketched two times by two radiographic doctors at different times,all data were analyzed by Image Processing Function of MATLAB R2010 a,and then the area,eccentricity ratio,anterior skew and posterior skew of neonatal corpus callosum were obtained. Results The area and posterior skew of corpus callosum in premature infant group were smaller than those in full-term infant group,and the anterior skew of corpus callosum in full-term infant group was smaller than that in premature infant group,the differences were statistically significant(all P<0.05).The eccentricity ratio of corpus callosum in premature infant group was smaller than that in full-term infant group,but the difference between the two groups as not statistically significant(P>0.05). Conclusions The development of premature infant corpus callosum is affected by prematurity,the size and shape of the corpus callosum differed between full-term infants and VLBW premature infants at term equivalent age.The corpus callosum was smaller and more circular in VLBW premature infants.