使用MRI限制胎儿生长中的胎儿大脑发育:系统性审查
L Meijerink1, I M van Ooijen2, T Alderliesten2
1Department of Obstetrics, Division Woman and Baby, University Medical Center Utrecht, location Wilhelmina Children's Hospital, Lundlaan 6, Utrecht, the Netherlands. l.meijerink-10@umcutrecht.nl.
BMC pregnancy and childbirth
|February 26, 2025
概括
胎儿生长限制 (FGR) 与大脑体积减少和多个大脑区域的明显扩散系数 (ADC) 降低有关. 需要进一步的研究来了解这些婴儿的长期神经认知结果.
科学领域:
- 神经科学是一个神经科学.
- 放射学 放射学是一门学科.
- 发展生物学 发展生物学
背景情况:
- 胎儿生长限制 (FGR) 影响胎儿发育,可能对大脑产生影响.
- 磁共振成像 (MRI) 提供了关于胎儿大脑发育的见解.
研究的目的:
- 系统地审查和比较胎儿大脑发育在FGR与适合妊娠年龄 (AGA) 胎儿使用MRI.
- 为了确定大脑体积,生物识别,扩散,代谢物和氧化量的特定差异.
主要方法:
- 在PubMed,Embase,Cochrane图书馆和科学网络 (1985-2023) 的系统文献搜索.
- 由估计的胎儿体重 (EFW)
- 对体积,生物识别,明显扩散系数 (ADC),1H-MRS代谢物和氧化数据的元分析.
主要成果:
- 包括29项研究;13项使用了Delphi共识对FGR的定义.
- 与AGA胎儿相比,FGR胎儿的总大脑体积显著减少 (MD -30.84 cm3,p<0.01) 和小脑体积 (MD -2.24 cm3,p<0.01).
- 在FGR胎儿的多个大脑区域 (FWM,OWM,TWM,thalami,CSO,基底,pons,小脑) 中观察到明显较低的ADC值.
- 在FGR胎儿的前额叶和中脑组织中减少了N-乙酸 (NAA):胆 (Cho) 和NAA:肌 (Cr) 的比率.
- 在分数移动的血液体积,上斜侧鼻静脉氧化或胎儿大脑中的T2*中没有显著差异.
结论:
- 核磁共振扫描显示了FGR和AGA胎儿之间大脑发育的显著差异,包括体积较小和扩散特征改变.
- 研究结果表明,FGR胎儿的大脑成熟和细胞完整性可能发生变化.
- 需要进一步的大规模研究来将这些MRI发现与长期神经认知结果相关联,并将大脑节省的FGR胎儿与对照进行比较.
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