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低级胚芽基质和脑室内出血新生儿的弥散峰度成像指标与神经发育结局之间的关

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2025-06-07 15:47

低级胚芽基质和脑室内出血新生儿的弥散峰度成像指标与神经发育结局之间的关系。

Chunxiang Zhang, Meiying Cheng, Zitao Zhu, Kaiyu Wang, Brianna F Moon, Sheng Shen, Bohao Zhang, Zihe Wang, Lin Lu, Honglei Shang, Chi Qin, Jinze Yang, Yu Lu, Xiaoan Zhang, Xin Zhao

摘要

扩散峰度成像（DKI）得出的指标被认为是低级胚芽基质和脑室内出血（GMH-IVH）新生儿的成熟指标。然而，这些因素是否与神经发育结果相关尚不清楚。本研究的目的是获取低度GMH-IVH新生儿的DKI衍生指标，并证明它们与日后神经发育结果的关联。在这项前瞻性研究中，招募了患有低度GMH-IVH的新生儿和对照组新生儿，并在2020年1月至2021年3月期间进行了DKI检查。这些新生儿在 18 个月大时接受了 Bayley 婴儿发展量表测试。测量了平均峰度（MK）、径向峰度（RK）和灰质值。对测量值和神经发育结果评分进行了斯皮尔曼相关分析。40名对照组（18名男性，平均胎龄（GA）30周±1.3，核磁共振扫描时校正的GA为38周±1）和30名患有低度GMH-IVH的新生儿（13名男性，平均胎龄（GA）30周±1.5，核磁共振扫描时校正的GA为38周±1）。低度 GMH-IVH 新生儿的 PLIC 和丘脑中的 MK 和 RK 值较低（P＜0.05）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Associations between diffusion kurtosis imaging metrics and neurodevelopmental outcomes in neonates with low-grade germinal matrix and intraventricular hemorrhage.

Diffusion Kurtosis Imaging (DKI)-derived metrics are recognized as indicators of maturation in neonates with low-grade germinal matrix and intraventricular hemorrhage (GMH-IVH). However, it is not yet known if these factors are associated with neurodevelopmental outcomes. The objective of this study was to acquire DKI-derived metrics in neonates with low-grade GMH-IVH, and to demonstrate their association with later neurodevelopmental outcomes. In this prospective study, neonates with low-grade GMH-IVH and control neonates were recruited, and DKI were performed between January 2020 and March 2021. These neonates underwent the Bayley Scales of Infant Development test at 18 months of age. Mean kurtosis (MK), radial kurtosis (RK) and gray matter values were measured. Spearman correlation analyses were conducted for the measured values and neurodevelopmental outcome scores. Forty controls (18 males, average gestational age (GA) 30 weeks ± 1.3, corrected GA at MRI scan 38 weeks ± 1) and thirty neonates with low-grade GMH-IVH (13 males, average GA 30 weeks ± 1.5, corrected GA at MRI scan 38 weeks ± 1). Neonates with low-grade GMH-IVH exhibited lower MK and RK values in the PLIC and the thalamus (P < 0.05). The MK value in the thalamus was associated with Mental Development Index (MDI) (r = 0.810, 95% CI 0.695-0.13; P < 0.001) and Psychomotor Development Index (PDI) (r = 0.852, 95% CI 0.722-0.912; P < 0.001) scores. RK value in the caudate nucleus significantly and positively correlated with MDI (r = 0.496, 95% CI 0.657-0.933; P < 0.001) and PDI (r = 0.545, 95% CI 0.712-0.942; P < 0.001) scores. The area under the curve (AUC) were used to assess diagnostic performance of MK and RK in thalamus (AUC = 0.866, 0.787) and caudate nucleus (AUC = 0.833, 0.671) for predicting neurodevelopmental outcomes. As quantitative neuroimaging markers, MK in thalamus and RK in caudate nucleus may help predict neurodevelopmental outcomes in neonates with low-grade GMH-IVH.

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