合成MRI定量评估妊娠高血压孕妇子代脑发育异常

Synthetic MRI in evaluation on abnormal brain development in offspring of pregnant women with gestational hypertension

目的 探讨合成MRI(SyMRI)定量评估妊娠高血压(GH)孕妇子代脑发育异常的价值。方法 选取25例GH孕妇分娩的早产儿为观察组,以33例无高危围产因素孕妇分娩的早产儿为对照组。行颅脑SyMRI,对比组间胼胝体压部、内囊后肢、额叶白质、枕叶白质、顶叶白质、半卵圆中心白质、丘脑腹外侧核、尾状核、豆状核及小脑的T1、T2值,观察其与纠正胎龄(PMA)的相关性;绘制受试者工作特征(ROC)曲线,评估各脑区T1、T2值诊断GH早产儿脑发育异常的效能。结果 观察组内囊后肢、顶叶白质、半卵圆中心白质、丘脑腹外侧核、尾状核及小脑T1、T2值均高于对照组(P均<0.05)。观察组内,除胼胝体压部、豆状核及小脑外,各脑区T1值均与PMA呈负相关;除额叶白质及小脑外,各脑区T2值均与PMA呈负相关(P均<0.05)。对照组内,除胼胝体压部外,各脑区T1值均与PMA呈负相关,各脑区T2值均与PMA呈负相关(P均<0.05)。ROC曲线结果显示,顶叶白质、丘脑腹外侧核T1、T2值及胼胝体压部T2值诊断GH早产儿脑发育异常的曲线下面积(AUC)均>0.70。结论 SyMRI有助于早期发现GH子代脑发育异常。

Objective To explore the value of synthetic MRI(SyMRI) in quantitative assessment of brain development abnormalities in offspring of pregnant women with gestational hypertension(GH). Methods Twenty-five premature babies delivered by pregnant women with GH were enrolled in observation group, while 33 premature babies delivered by pregnant women without high-risk perinatal factors were taken as controls(control group). Cerebral SyMRI was performed in both groups. T1 and T2 values of splenium of corpus callosum, posterior limb of internal capsule, frontal white matter, occipital white matter, parietal white matter, central semiovale white matter, ventral lateral nucleus of thalamus, caudate nucleus, lentiform nucleus and cerebellum were compared between groups. The correlations of T1, T2 values and postmenstrual age(PMA) were analyzed. Receiver operating characteristic(ROC) curves were drawn, and the efficacy of T1 and T2 values of brain region in diagnosis of abnormal brain development in premature infants with GH were evaluated. Results T1 and T2 values of posterior limb of internal capsule, parietal white matter, central semiovale white matter, ventral lateral nucleus of thalamus, caudate nucleus and cerebellum in observation group were higher than those in control group(all P<0.05). In observation group, except splenium of corpus callosum, lentiform nucleus and cerebellum, T1 values of brain regions were negatively correlated with PMA, while T2 values of brain regions were negatively correlated with PMA(all P<0.05) except frontal white matter and cerebellum. In control group, T1 values of all brain regions except splenium of corpus callosum were negatively correlated with PMA, T2 values of all brain regions were negatively correlated with PMA(all P<0.05). ROC curve results showed that the area under the curve(AUC) of T1 and T2 values of parietal white matter and ventrolateral thalamic nucleus, as well as of T2 values of corpus callosum for diagnosing brain dysplasia in premature infants with GH were all >0.70. Conclusion SyMRI was helpful for early detection of abnormal brain development in GH offspring.