Objective To investigate local cerebral blood perfusion in preterm infants with bronchopulmonary dysplasia (BPD) based on cerebral blood flow (CBF) values of arterial spin labeling (ASL). Methods A prospective study was conducted on 90 preterm infants with a gestational age of <32 weeks and a birth weight of <1 500 g who were born in the Department of Obstetrics and admitted to the Department of Neonatology in the Third Affiliated Hospital of Zhengzhou University from August 2021 to June 2022. All of the infants underwent cranial MRI and ASL at the corrected gestational age of 35-40 weeks. According to the presence or absence of BPD, they were divided into a BPD group with 45 infants and a non-BPD group with 45 infants. The two groups were compared in terms of the CBF values of the same regions of interest (frontal lobe, temporal lobe, parietal lobe, occipital lobe, thalamus, and basal ganglia) on ASL image. Results Compared with the non-BPD group, the BPD group had a significantly lower 1-minute Apgar score, a significantly longer duration of assisted ventilation, and a significantly higher incidence rate of fetal distress (P<0.05). After control for the confounding factors such as corrected age and age at the time of cranial MRI by multiple linear regression analysis, compared with the non-BPD group, the BPD group still had higher CBF values of the frontal lobe, temporal lobe, parietal lobe, occipital lobe, basal ganglia, and thalamus at both sides (P<0.05). Conclusions BPD can increase cerebral blood perfusion in preterm infants, which might be associated with hypoxia and a long duration of assisted ventilation in the early stage.
Key words
Bronchopulmonary dysplasia /
Arterial spin labeling /
Cerebral blood flow /
Preterm infant
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
1 Cao Y, Jiang S, Sun J, et al. Assessment of neonatal intensive care unit practices, morbidity, and mortality among very preterm infants in China[J]. JAMA Netw Open, 2021, 4(8): e2118904. PMID: 34338792. PMCID: PMC8329742. DOI: 10.1001/jamanetworkopen.2021.18904.
2 Bae SP, Shin SH, Yoon YM, et al. Association of severe retinopathy of prematurity and bronchopulmonary dysplasia with adverse neurodevelopmental outcomes in preterm infants without severe brain injury[J]. Brain Sci, 2021, 11(6): 699. PMID: 34073292. PMCID: PMC8226991. DOI: 10.3390/brainsci11060699.
3 Martin M, Smith L, Hofheimer JA, et al. Bronchopulmonary dysplasia and neurobehavioural outcomes at birth and 2 years in infants born before 30 weeks[J]. Arch Dis Child Fetal Neonatal Ed, 2022. Epub ahead of print. PMID: 35999044. DOI: 10.1136/archdischild-2021-323405.
4 Neubauer V, Junker D, Griesmaier E, et al. Bronchopulmonary dysplasia is associated with delayed structural brain maturation in preterm infants[J]. Neonatology, 2015, 107(3): 179-184. PMID: 25632975. DOI: 10.1159/000369199.
5 Lee JM, Choi YH, Hong J, et al. Bronchopulmonary dysplasia is associated with altered brain volumes and white matter microstructure in preterm infants[J]. Neonatology, 2019, 116(2): 163-170. PMID: 31112968. DOI: 10.1159/000499487.
6 Alsop DC, Detre JA, Golay X, et al. Recommended implementation of arterial spin-labeled perfusion MRI for clinical applications: a consensus of the ISMRM Perfusion Study Group and the European Consortium for ASL in Dementia[J]. Magn Reson Med, 2015, 73(1): 102-116. PMID: 24715426. PMCID: PMC4190138. DOI: 10.1002/mrm.25197.
7 Bouyssi-Kobar M, Murnick J, Brossard-Racine M, et al. Altered cerebral perfusion in infants born preterm compared with infants born full term[J]. J Pediatr, 2018, 193: 54-61.e2. PMID: 29212618. PMCID: PMC5794508. DOI: 10.1016/j.jpeds.2017.09.083.
8 Higgins RD, Jobe AH, Koso-Thomas M, et al. Bronchopulmonary dysplasia: executive summary of a workshop[J]. J Pediatr, 2018, 197: 300-308. PMID: 29551318. PMCID: PMC5970962. DOI: 10.1016/j.jpeds.2018.01.043.
9 邵肖梅, 叶鸿瑁, 丘小汕. 实用新生儿学[M]. 5版. 北京: 人民卫生出版社, 2019.
10 DeMauro SB. Neurodevelopmental outcomes of infants with bronchopulmonary dysplasia[J]. Pediatr Pulmonol, 2021, 56(11): 3509-3517. PMID: 33749169. DOI: 10.1002/ppul.25381.
11 Drummond D, Hadchouel A, Torchin H, et al. Educational and health outcomes associated with bronchopulmonary dysplasia in 15-year-olds born preterm[J]. PLoS One, 2019, 14(9): e0222286. PMID: 31509594. PMCID: PMC6738652. DOI: 10.1371/journal.pone.0222286.
12 Kline JE, Illapani VSP, He L, et al. Early cortical maturation predicts neurodevelopment in very preterm infants[J]. Arch Dis Child Fetal Neonatal Ed, 2020, 105(5): 460-465. PMID: 31704737. PMCID: PMC7205568. DOI: 10.1136/archdischild-2019-317466.
13 Alisch JSR, Khattar N, Kim RW, et al. Sex and age-related differences in cerebral blood flow investigated using pseudo-continuous arterial spin labeling magnetic resonance imaging[J]. Aging (Albany NY), 2021, 13(4): 4911-4925. PMID: 33596183. PMCID: PMC7950235. DOI: 10.18632/aging.202673.
14 Kline JE, Illapani VSP, He L, et al. Retinopathy of prematurity and bronchopulmonary dysplasia are independent antecedents of cortical maturational abnormalities in very preterm infants[J]. Sci Rep, 2019, 9(1): 19679. PMID: 31873183. PMCID: PMC6928014. DOI: 10.1038/s41598-019-56298-x.
15 王银娟, 刘沙沙, 刘彦超, 等. 应用弥散张量成像评价支气管肺发育不良早产儿脑白质发育的研究[J]. 中国当代儿科杂志, 2020, 22(10): 1079-1084. PMID: 33059804. PMCID: PMC7568998. DOI: 10.7499/j.issn.1008-8830.2004236.
16 Bouyssi-Kobar M, De Asis-Cruz J, Murnick J, et al. Altered functional brain network integration, segregation, and modularity in infants born very preterm at term-equivalent age[J]. J Pediatr, 2019, 213: 13-21.e1. PMID: 31358292. PMCID: PMC6765421. DOI: 10.1016/j.jpeds.2019.06.030.
17 Kanaan A, Farahani R, Douglas RM, et al. Effect of chronic continuous or intermittent hypoxia and reoxygenation on cerebral capillary density and myelination[J]. Am J Physiol Regul Integr Comp Physiol, 2006, 290(4): R1105-R1114. PMID: 16322350. DOI: 10.1152/ajpregu.00535.2005.
18 da Cunha MJ, da Cunha AA, Loureiro SO, et al. Experimental lung injury promotes changes in oxidative/nitrative status and inflammatory markers in cerebral cortex of rats[J]. Mol Neurobiol, 2015, 52(3): 1590-1600. PMID: 25367887. DOI: 10.1007/s12035-014-8961-9.
19 Fassbender K, Hodapp B, Rossol S, et al. Inflammatory cytokines in subarachnoid haemorrhage: association with abnormal blood flow velocities in basal cerebral arteries[J]. J Neurol Neurosurg Psychiatry, 2001, 70(4): 534-537. PMID: 11254783. PMCID: PMC1737308. DOI: 10.1136/jnnp.70.4.534.
20 Fassbender K, Ries S, Schminke U, et al. Inflammatory cytokines in CSF in bacterial meningitis: association with altered blood flow velocities in basal cerebral arteries[J]. J Neurol Neurosurg Psychiatry, 1996, 61(1): 57-61. PMID: 8676162. PMCID: PMC486459. DOI: 10.1136/jnnp.61.1.57.
PDF(760 KB)
