| PurposeTo study how diffuse tensor imaging can evaluate the impact of pregnancy-induced hypertension on the brain development of preterm infants,and to make early diagnosis of long-term neurobehavioral disorders of preterm infants with hypertension during pregnancy.MethodSeventy-eight premature babies who were admitted to the neonatal intensive care unit of the Third Affiliated Hospital of Zhengzhou University from February 2018 to June 2019 were selected to exclude newborns with jaundice or other causes of craniocerebral injury.According to the pregnancy Stage hypertension is divided into a case group and a control group.Routine cranial magnetic resonance imaging(MRI)and diffusion tensor imaging are performed when the gestational age is 33 to 37 weeks,and the FA values of the two regions of interest are measured and compared.Correlation analysis was performed between the white matter FA value and Apgar score of preterm infants in the case group.Collect perinatal data of two groups of premature babies,and compare the basic examination,in-hospital treatment process and comorbidities between the two groups.Craniocerebral ultrasonography was performed before magnetic resonance examination,and premature infants were divided into brain injury group and no brain injury group according to the results of magnetic resonance examination.Premature infants with multiple types of brain injury were excluded,and brain injury components were further divided.For five subgroups,the detection rates of magnetic resonance and craniocerebral ultrasound for different types of brain injury were compared.Long-term follow-up to 6 months,referring to the Infant and Child Intelligence Development Scale(CDCC)prepared by the Institute of Psychology,Chinese Academy of Sciences,and performing neurobehavioral tests at 1 month,3 months,and 6 months,respectively.The neurobehavioral abnormalities in the hypertensive and nonhypertensive groups were compared.Result1.Comparison of general information between the two groups:including gender,gestational age at birth,birth/cesarean section,birth weight,corrected gestational age at MRI examination,maternal age≥35 or≤0 years,maternal education(junior high school and below).There was no significant difference in the general information between the two groups(P>0.05)2.Comparison of clinical data between the two groups:history of asphyxia,respiratory failure,tracheal intubation and mechanical ventilation,neonatal respiratory distress syndrome(NRDS),pneumonia,anemia,hypoglycemia,and open ductus arteriosus.There was no significant difference in clinical data between the two groups(P>0.05)3.Corrected FA values of magnetic resonance examination at 33 to 37 weeks of gestational age in two groups:average values of FA values of the inner capsule hindlimbs,corpus callosum,thalamus,frontal white matter,parietal white matter,and cerebral feet of preterm infants in the case group Compared with the control group,the difference was statistically significant(all P<0.05),and the average FA values were less than the case group(all P<0.05).4.Correlation analysis between FA value and Apgar score of frontal white matter in preterm infants with hypertension in pregnancy group:There was no significant correlation between FA value of frontal white matter FA and Apgar score at 1 min and 5 min after birth in the case group(r=0.244,P>0.05;r=0.273,P>0.05).5.Comparison of magnetic resonance and craniocerebral brain injury detection rate results:When the gestational age was corrected from 33 to 37 weeks,the detection rates of PWMD and DWMD by cranial magnetic resonance were significantly higher than those of cranial ultrasound,and there were statistical differences at P<0.05.The significance of MRI and US was the same in the PVL group and PIVH-IVH group.In the SAH group,the skull ultrasound detection rate was lower than that of MRI.6.Comparison of the follow-up results between the two groups:the neurobehavioral abnormality in the case group(14 cases)and the control group(4 cases).The number of neurobehavioral abnormalities in the case group was significantly higher than that in the control group and the difference was statistically significant(P<0.05).In conclusion(1)Multi-modal magnetic resonance can make early diagnosis of brain development lag in premature infants caused by maternal hypertension during pregnancy;(2)When the gestational age is 33 to 37 weeks,the detection rate of brain injury is higher than that of craniocerebral ultrasound;(3)Compared with the Apgar score,magnetic resonance imaging can more accurately reflect the true brain development of preterm infants at birth;(4)Multimodal magnetic resonance can predict the long-term prognosis of preterm infants with hypertension in pregnancy,so as to provide reference value for early clinical intervention. |
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