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早产儿静息态功能磁共振ALFF随访分析*

作者:王宏伟 向 葵 干芸根

所属单位:广东省深圳市儿童医院放射科(广东 深圳 518038)

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摘要

目的 探讨静息态功能磁共振 ALFF分析在早产儿脑发育的应用价值。方 法 对25例早产儿在生后6个月时行MR检 查,并按年龄匹配原则招募21例正常婴儿 进行MR检查以建立MR数据正常对照组,MR 检查包括fMRI,3D-T1WI。采用低频振幅 (ALFF)算法观察和比较早产儿在生后6个 月不同大脑区域 ALFF的变化。结果 和正 常对照组相比,在小脑后叶、额叶和上辅 助运动脑区功ALFF减弱,早产儿6个月随 访组在颞上回和前扣带回脑区ALFF增强。 结论 早产儿生后的脑发育过程与正常足 月儿的发育过程不同,影响这些神经网络 的成熟,在颞上回和前扣带回脑区ALFF活 动增强提示早产儿脑内可能存在调整效 应。

Objective To study the differences and its significance of ALFF values of the brain using resting-state fMRI(RS.fMRI) in premature and full-term infants at 6 months after birth. Methods 25 premature infants and 21 normal full-term infants were recruited from Shenzhen children Hospital, and screened using RS.fMRI at 6-month after birth. Amplitude of low frequency fluctuation(ALFF) of different brain regions was compared between premature and ful-term infants. Results The RS.fMRI showed that the premature infants had significant decrease of ALFF in cerebellum posterior lobe, frontal Lobe, supp motor Area, while they had significant increase in superior temporal gyrus and anterior cingulate. Conclusion In resting-state, the preterm infants at 6-month after birth have decreased brain activity in many brain regions including cerebellum posterior lobe, frontal Lobe, supp motor Area, however, increased activity in superior temporal gyrus and anterior cingulate might be a kind of adaptation development in the premature brain.

【关键词】早产;静息态功能性磁共振成像;低频振幅

【中图分类号】R722

【文献标识码】A

【DOI】10.3969/j.issn.1672- 5131.2017.01.006

前言

 早产是当今公共健康的一个主要问题,多达1/3的早产儿于幼儿期 即出现认知障碍[1],早产也影响大脑皮层的发育过程[2]。研究表明很 多早产儿在青少年时的大脑功能是正常的,表明在早产儿的脑功能发 育过程中存在着调整过程,但到目前为止脑发育调整的神经生物学机 制仍未明确[3]。Raichle等发现人脑的默认网络活动,在脑静息状态下 依然存在,并认为其与广泛神经类疾病相关,然而多数研究对象是已 表现出病症的学龄期儿童或成人[4]。静息态功能磁共振成像(restingstate function magnetic resonance imaging,RS.fMRI)是无创性检 查技术,可以探测静息时脑的自发活动状态。低频振幅(amplitude of low-frequency fluctuation,ALFF)算法可以检测静息状态下脑神经 元自发活动的强度。本研究以25例早产儿为研究对象,在生后6个月进 行RS.fMRI随访扫描,采用ALFF算法,探测静息状态下脑神经元自发活 动的强度变化,并与正常对照组比较分析脑神经元自发活动的差异及 意义。