基于T2WI的视觉评估方法在筛查脑室周围白质软化症婴幼儿白质髓鞘化发育进程中的应用价值

Assessment of myelination progression in subcortical white matter of infant with periventricular leukomalacia using T2-weighted imaging based visual scoring method

目的运用基于T2WI视觉评估方法评价6~20月龄脑室周围白质软化症(periventricularleukomalacia,PVL)及对照组婴幼儿皮层下白质髓鞘化发育进程,验证该方法筛查性评价婴幼儿皮层下白质髓鞘化发育进程的应用价值。材料与方法纳入2010年11月至2017年6月间接受磁共振检查的43例PVL及78例MRI未见异常的6~20月龄婴幼儿。PVL分轻、中、重度3组。运用基于常规T2WI视觉评估皮层下白质髓鞘化发育进程的评分方法,评价并获得各组婴幼儿的白质髓鞘化分数。通过Mann-Whitney U检验,比较各组髓鞘化分数;通过线性回归及Spearman相关分析探索PVL各组、对照组全脑及各脑叶皮层下白质髓鞘化分数随龄性变化。P<0.05认为有统计学意义。结果 6~20月龄阶段,PVL轻度组仅顶叶皮层下白质髓鞘化分数与对照有统计学差异(P=0.033);除颞叶外,PVL中度组及重度组的皮层下白质髓鞘化分数与对照组均有差异(P<0.05)。Spearman相关分析结果示对照组皮层下白质髓鞘化分数与年龄的相关性高于PVL组。结论基于T2WI的视觉评估方法在筛查不同程度PVL所致的异常皮层下白质髓鞘化发育进程中,具有良好的可行性。同时,该方法可根据白质髓鞘化发育进程鉴别轻度和中重度PVL。

Objective:The purpose of this study was to assess the subcortical white matter (WM) myelination progress via T2-weighted imaging (T2WI) based visual scoring method in the infant of periventricular leukomalacia (PVL) during age of 6-20 months and validate the applicability of this scoring method in screening abnormal WM myelination progress in infant with PVL.Materials and Methods:We retrospectively recruited infant with diagnosis of PVL,and infant without abnormalities on MRI during age of 6-20 months from November 2010 to June 2017.Infant with PVL were divided into three groups:mild,moderate and severe.Subcortical WM myelination progress of infant in control group,PVL groups was assessed via the T2WI-based visual scoring method.Then myelination scores of regional and whole brain were compared between different PVL groups and control group using Mann-Whitney U test.Then linear regression and Spearman correlations were applied to assess the association between myelination score and age in the control and PVL groups.Results:In this study,the significant difference in subcortical WM myeliantion score of parietal lobe was found between mild PVL group and control group (P=0.033);and except temproal lobe,other brain lobes were observed differences in subcortical WM myeliantion score between moderate,severe PVL groups and control group.The positive linear correlations between age and the myeliantion score were found in both PVL groups and control group (P<0.05).And the correlation coefficients of control group were higher than PVL groups.Conclusions:The T2WI-based visual scoring method was useful and applicable in screening myelination progress of the moderate and severe PVL in infant aged 6-20 months in clinic.