ABSTRACT

Objective: Evaluate longitudinal changes in brain microstructure and volumes in very preterm infants during the first year of life with and without intervention.

Design: Descriptive pilot study.

Methods: Five preterm infants in a three-arm clinical trial, one SPEEDI Early, two SPEEDI Late, and two usual care. Brain structural and diffusion MRI’s were acquired within 72 hours after neonatal intensive care unit discharge (n = 5), three months post-baseline (n = 5), and six months post-baseline (n = 3). Fractional anisotropy (FA), Mean diffusivity (MD), and volume metrics were computed for five brain regions.

Results: More than 60% of eligible participants completed 100% of the scheduled MRIs. FA and volume increased from baseline to six months across all brain regions. Rate of white matter volume change from baseline to six months was highest in SPEEDI Early.

Conclusions: Non-sedated longitudinal MRI is feasible in very preterm infants and appears to demonstrate longitudinal changes in brain structure and connectivity.

摘要

目的：评估极早产儿在有和没有干预的情况下在出生后第一年大脑微观结构和体积的纵向变化。

设计：描述性试验研究。

方法：三组临床试验中的 5 名早产儿、1 名 SPEEDI 早期、2 名 SPEEDI 晚期和 2 名常规护理。在新生儿重症监护室出院后 72 小时内 (n = 5)、基线后三个月 (n = 5) 和基线后六个月 (n = 3) 获得脑结构和扩散 MRI。计算了五个大脑区域的分数各向异性 (FA)、平均扩散率 (MD) 和体积指标。

结果：超过 60% 的合格参与者完成了 100% 的预定 MRI。所有大脑区域的 FA 和体积从基线增加到六个月。在 SPEEDI Early 中，白质体积从基线到 6 个月的变化率最高。

结论：非镇静纵向 MRI 在极早产儿中是可行的，并且似乎显示了大脑结构和连通性的纵向变化。