弥散张力成像应用于早产儿脑白质损伤的研究进展

Research progress of diffusion tensor imaging applied to white matter injury in premature infants.

脑白质损伤主要发生在<32周白质发育未成熟的早产儿,是造成慢性神经系统发育不良的主要原因,大多会留有神经系统后遗症,对家庭和社会造成极大负担。颅脑彩超和振幅整合脑电图是筛查早产儿脑损伤的主要方法,对非囊性脑白质损伤的敏感性不高。传统的MRI对检测更微小及非囊性病变优于头颅彩超,但不能量化白质损伤程度,在早产儿脑白质损伤的评估中作用有限。弥散张力成像能够可视化白质结构,评估白质纤维髓鞘化程度,是目前唯一可用于研究白质纤维的无创技术,对大脑的微观结构变化更敏感。因此本文就早产儿WMI、DTI检查优势及原理,以及DTI在早产儿脑发育、WMI疾病等应用进展做一综述。

Cerebral white matter injury(WMI)mainly occurs in premature infants with less than 32 weeks of white matter development,which is the main cause of chronic nervous system dysplasia.Most of them will have neurological sequelae and cause great burden to the family and society.Craniocerebral color doppler ultrasonography and amplitude-integrated electroencephalogram(aEEG)are the main methods to screen premature infants with brain injury.Conventional MRI is superior to cephalic ultrasound in detecting smaller and non-cystic lesions,but it cannot quantify the extent of white matter damage,and its role in the assessment of white matter damage in premature infants is limited.Diffusion tensor imaging(DTI)can visualize the structure of white matter and evaluate the degree of myelin sheath of white matter fibers.It is the only non-invasive technique available to study white matter fibers at present and is more sensitive to brain microstructure changes.Therefore,this article summarizes the advantages and principles of WMI and DTI in premature infants,and the application progress of DTI in brain development and WMI diseases in premature infants.