目的探讨早产儿与足月儿静息态功能磁共振成像(RS-fMRI)脑默认网络的差异及意义。方法选择2012—2013年第三军医大学大坪医院儿科收治的新生儿进行RS-fMRI扫描筛查。通过采用低频振幅(ALFF)算法观察和比较早产儿组与足月儿组不同大脑区域ALFF的增强及减弱。结果研究期间共招募85例新生儿,排除39例脑损伤显著和图像预处理不符合标准者,共46例新生儿的结果纳入后续研究分析。17例早产儿与29例足月儿的RS-fMRI结果显示,与足月儿相比,早产儿大脑内侧前额叶皮层、额下回、眶额皮层、壳核、前颞叶、中间颞叶、前扣带回、后扣带回、中扣带回、苍白球、旁海马皮质脑区ALFF减弱,楔前叶、距状裂皮质ALFF增强。结论静息状态下,早产儿在额叶和颞叶等脑区功能活动显著减低,但部分集中在视觉区域的功能活动增强,提示早产儿脑内可能存在补偿效应。
Objective To study the differences and its significance of default mode network of the brain using resting-state fMRI( RS-fMRI) in premature and full-term infants. Methods Neonates were recruited from Department of Pediatrics,Daping Hospital,Third Military Medical University during2012-2013 and screened using RS-fMRI. Amplitude of low frequency fluctuation( ALFF) of different brain regions was compared between premature and full-term infants. Results A total of 85 neonates were recruited and screened during the study and 39 were excluded because of significant brain injury and in conformity of image preprocessing. A total of 46 neonates were included. Among 17 premature and29 full-term infants,the RS-fMRI showed that the premature infants had significant decrease of ALFF in the medial prefrontal cortex(MPFC),inferior frontal gyrus(IFG),inferior orbitofrontal cortex,putamen,anterior temporal lobe(ATL),middle temporal lobe( MTL),anterior cingulate cortex( ACC),posterior cingulate cortex( PCC),middle cingulate cortex( MCC),palladium,and parahippocampal cortex(PHC),while they had significant increase in precuneus(PCu)and calcarine cortex. Conclusions In resting-state,the preterm infants have decreased brain activity in many brain regions including frontal lobe and temporal lobe. However,increased activity in the visual area might be a kind of compensation effect in the premature brain.