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Magnetic resonance imagining findings of the white matter abnormalities in the brain of very-low-birth-weight infants
ÃÖÀçÇõ, À念ǥ,
¼Ò¼Ó »ó¼¼Á¤º¸
ÃÖÀçÇõ ( Choi Jae-Hyuk )
´Ü±¹´ëÇб³ ÀÇ°ú´ëÇÐ ¼Ò¾Æ°úÇб³½Ç
À念ǥ ( Chang Young-Pyo )
´Ü±¹´ëÇб³ ÀÇ°ú´ëÇÐ ¼Ò¾Æ°úÇб³½Ç
KMID : 1130320090520101127
Abstract
¸ñ Àû : ±Ø¼Ò ÀúüÁß Ãâ»ý¾Æ¿¡¼ ±³Á¤ ÁÖ¼ö ¸¸»è(40ÁÖ) ±Ùó¿¡ ½ÃÇàÇÑ ³ú MRI ¼Ò°ß¿¡¼ ³ú¹éÁú ÀÌ»ó ¼Ò°ßÀ» °üÂûÇÏ°í Ãø³ú½Ç ºÎÀ§ ¹éÁú¿¬ÈÁõ ¹ß»ý°ú °ü·Ã ÀÖ´Â ÀÓ»ó À§Çè ÀÎÀÚ¸¦ °üÂûÇÏ°íÀÚ ÇÏ¿´´Ù.
¹æ ¹ý : ±³Á¤ ÁÖ¼ö ¸¸»è(40ÁÖ) ±Ùó¿¡ ³ú MRI¸¦ ½ÃÇàÇÑ ±Ø¼Ò ÀúüÁß Ãâ»ý¾Æ 98¸íÀ» ´ë»óÀ¸·Î ³ú MRIÀÇ ³ú¹éÁú ÀÌ»ó ¼Ò°ßÀ» °üÂûÇÏ¿´´Ù. ³ú¹éÁú ÀÌ»ó ¼Ò°ß Áß ³¶¼º ¶Ç´Â ºñ³¶¼º Ãø³ú½Ç ºÎÀ§ ¹éÁú ¿¬ÈÁõ ȯ¾ÆµéÀÇ ÀÓ»ó ¼Ò°ßÀ» °üÂûÇÏ¿© Ãø³ú½Ç ºÎÀ§ ¹éÁú¿¬ÈÁõÀÇ ¹ß»ý°ú °ü·ÃµÈ ÀÓ»ó À§Çè ÀÎÀÚ¸¦ °üÂûÇÏ°íÀÚ ÇÏ¿´´Ù.
°á °ú : 1) 98¸íÀÇ È¯¾Æ Áß DEHSI°¡ 74¸í(75.5%), ³ú½Ç È®ÀåÀº 17¸í(17.3%), ±¹¼Ò ¹éÁú À½¿µ Áõ°¡´Â 5¸í(5.1%), Ãø³ú½Ç ºÎÀ§ ³¶¼º ¼Ò°ßÀº 11¸í(11.2%), Á¾ÀÚÃþ ÃâÇ÷ ¶Ç´Â »óÀÇ ÇÏ ³¶Á¾ÀÌ 9¸í(9.1%), ³ú½Ç ³» ÃâÇ÷ÀÌ 3¸í(3.1%), ÃâÇ÷ ÈÄ ³ú¼öÁ¾ÀÌ 2¸í(2.0 %), Ãø³ú½Ç ºÎÀ§ ÃâÇ÷¼º °æ»öÀÌ 2¸í(2.0%) °üÂûµÇ¾ú´Ù. 2) Ãø³ú½Ç ºÎÀ§ ¹éÁú¿¬ÈÁõ ¹ß»ý°ú °ü·ÃµÈ ÀÓ»ó À§Çè ÀÎÀڷδ ³¶¼º Ãø³ú½Ç ºÎÀ§ ¹éÁú¿¬ÈÁõ¿¡¼´Â ÀçÅ ±â°£, 1ºÐ Apgar Á¡¼ö, CRIB-II Á¡¼ö, Ç÷¾Ð »ó½ÂÁ¦ Åõ¿©°¡, ºñ³¶¼º Ãø³ú½Ç ºÎÀ§ ¹éÁú¿¬ÈÁõ¿¡¼´Â ÀçÅ ±â°£, CRIB-II Á¡¼ö, Ãâ»ý ÈÄ ½ºÅ×·ÎÀ̵å Åõ¿©, Ç÷¾Ð »ó½ÂÁ¦ Åõ¿©, Ãâ»ý ½Ã ºñÁ¤»óÀûÀÎ ¹éÇ÷±¸ ¼öÄ¡ µîÀÌ Åë°èÀûÀ¸·Î ÀÇ¹Ì ÀÖ¾ú´Ù(P<0.05). ·ÎÁö½ºÆ½ ȸ±ÍºÐ¼®¿¡¼´Â ³¶¼º Ãø³ú½Ç ºÎÀ§ ¹éÁú¿¬ÈÁõ¿¡¼´Â CRIB-II Á¡¼ö(odd ratio, 1.63, 95% confidence interval, 1.15, 2.30, P=0.006)°¡ ºñ³¶¼º Ãø³ú½Ç ºÎÀ§ ¹éÁú¿¬ÈÁõ¿¡¼´Â ÀçÅ ±â°£(odd ratio 0.90, 95% confidence interval, 0.82, 0.99, P=0.036)ÀÌ µ¶¸³ÀûÀÎ À§Çè ÀÎÀÚ¿´´Ù.
°á ·Ð : ±³Á¤ ÁÖ¼ö ¸¸»è ±Ùó¿¡ ½ÃÇàÇÑ ±Ø¼Ò ÀúüÁß Ãâ»ý¾ÆÀÇ ³ú MRI´Â ´Ù¾çÇÑ ³ú¹éÁú ÀÌ»ó ¼Ò°ßÀ» º¸¿´°í, Ãø³ú½Ç ºÎÀ§ ¹éÁú¿¬ÈÁõ ¹ß»ý°ú ¿¬°üµÈ ÀÓ»ó À§Çè ÀÎÀڷδ CRIB-II Á¡¼ö¿Í ÀçÅ ±â°£ÀÌ ÀÇ¹Ì ÀÖ¾ú´Ù.
Purpose : To observe the abnormal white matter findings on the magnetic resonance imaging (MRI) scans of very-low- birth-weight (VLBW) infant brains at term-equivalent age and to determine the clinical risk factors for the development of periventricular leukomalacia (PVL).
Methods : In all, MRI was performed in 98 VLBW infants and the white matter abnormalities were observed. Clinical risk factors for cystic and noncystic PVL were determined.
Results : MRI scans of 74 infants (75.5%) showed diffuse excessive high signal intensity (DEHSI) in the periventricular white matter, 17 (17.3%) lateral ventricle dilation, 5 (5.1%) and 11 (11.2%) focal punctate lesions and cystic changes in the periventricular white matter, respectively, 9 (9.1%), germinal layer hemorrhage (GLH) or subependymal cysts 3 (3.1%) intraventricular hemorrhage (>grade 2) 2 (2.0%) posthemorrhagic hydrocephalus and 2 (2.0%) periventricular hemorrhagic infarct. Gestational age (GA), 1-minute Apgar score, Clinical Risk Index for Babies-II (CRIB-II) score, and inotrope use, and GA, CRIB-II score, postnatal steroid administration, inotrope use, and abnormal white blood cell (WBC) count at admission were related to cystic PVL and noncystic PVL development, respectively (P<0.05). However, in logistic regression analysis, CRIB-II (odds ratio, 1.63, 295% confidence interval, 1.15?2.30 P=0.006) for cystic PVL, and GA (odds ratio 0.90, 95% confidence interval, 0.82?0.99 P=0.036) for noncystic PVL were only significant independently.
Conclusion : White matter abnormalities could be observed on MRI scans of the VLBW infant brains at term-equivalent age, and CRIB-II and GA were only independently significant for cystic and noncystic PVL development, respectively.
Å°¿öµå
Leukomalacia;Periventricular;Magnetic resonance imaging; Infant;Very low birth weight
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