Combined use of MRI and 1 H proton magnetic resonance spectroscopy on the detection of brain metabolites and different brain areas of volume in small for gestational age / 中国小儿急救医学

ABSTRACT

Objective By 1 H magnetic resonance spectroscopy( 1 H MRS) ,small for gestational age (SGA)and appropriate for gestational age(AGA) as the detection of brain metabolites and MRI plus soft-ware measurement in different brain areas of volume,investigate its cerebral metabolites and the changes of brain in different parts of the volume and significance. Methods Select 88 patients eligible infants, SGA group of 27 cases and AGA group of 21 cases of premature infants;SGA group of 22 cases and AGA group of 18 cases of term infants. Preterm infants with a gestational age of 32 to 36 weeks,term infants with a gesta-tional age of 37 to 41 weeks. Check time between 4 to 7 days old. Calculation of cerebrum volume,cerebellar volume and cerebrospinal fluid volume and intracranial volume,N-acetylaspartic acid(NAA),as 1H MRS area of metabolites measured right frontal choline compounds( Cho) and creatine compounds( Cr) wave,calcu-lation of Cho/Cr and NAA/Cho ratio of NAA/Cr. Results NAA/Cr,the cerebrum volume and intracranial volume of SGA in premature infants group,term infants group and mixed group were 0. 627 ± 0. 183,(2. 831 ±0. 199) ×105 mm3,(3. 178 ±0. 209) ×105 mm3;0. 706 ±0. 139,(3. 056 ±0. 217) ×105 mm3,(3. 411 ± 0. 212 ×105 mm3;0. 708 ± 0. 171,(2. 932 ± 0. 234) × 105 mm3,(3. 282 ± 0. 239) × 105 mm3,respective-ly. NAA/Cr,the cerebrum volume and intracranial volume of AGA in premature infants group,term infants group and mixed group were 0. 734 ± 0. 101,(2. 987 ± 0. 111) × 105 mm3,(3. 347 ± 0. 137) × 105 mm3;0. 805 ± 0. 106, ( 3. 228 ± 0. 284 ) × 105 mm3 , ( 3. 588 ± 0. 306 ) × 105 mm3; 0. 721 ± 0. 119, ( 3. 098 ± 0.240) ×105 mm3,(3.458 ±0.258) ×105 mm3,respectively. The data of SGA group were all lower than those in AGA group,which had significant difference(P0. 05,respectively). In the premature infants groups,the NAA/Cho of SGA group(0. 401 ± 0. 737) was lower than in the AGA group(0. 506 ± 0. 116), which had significant difference(P=0. 000). In the term infants groups,the NAA/Cho of SGA group(0. 483 ±0. 605) was lower than in the AGA group(0. 472 ± 0. 987),which had no significant difference(P =0. 653). In the AGA groups,NAA/Cr,NAA/Cho,cerebellar volume and cerebrospinal fluid volume of pre-mature infants group and term infants group had no significant difference ( P>0. 05 ) . Both of the cerebellar volume and cerebrospinal fluid volume between the premature infants AGA group and premature infants AGA group had no significant difference(P>0. 05). Conclusion Neurons in the brain,the cerebrum volume,the cranial cavity volume and NAA/Cr of SGA was significantly lower than those of AGA,but Cho/Cr,cerebel-lar volume and cerebrospinal fluid volume of SGA and AGA had no significant difference. NAA/Cr in the brain and the cerebrum volume of SGA may be associated with low volume of small nerve mental retarda-tion,worthy of further study.