Abstract: 【Abstract】 Objective According to the conventional magnetic resonance imaging （T1WI, T2WI）and diffusion weighted imaging （DWI）, we can make sure the best time to do MRI and evaluate the prognosis for the late preterm infants. Method A total of 649 late preterm infants were enrolled and received the MRI scans with the sequences of conventional MRI and DWI. 271 cases were diagnosed CWMD. To investigate the early MRI signal characteristics of different types CWMD. And the 76 cases were followed up, to study the dynamic change rule. Result In the 271 late preterm infants with CWMD, 170 cases showed focal CWMD, 77 cases showed wide spread CWMD and 24 cases diffuse CWMD. The first time that they received magnetic resonance imaging was （8.3±6.4）（1.7-14.7）d, and the second time was （19.9±5.2）（14.7-25.1）d. There were 36 cases of lesions range reduced, and 23 cases disappeared. But 17 cases （6.3%）showed different degrees of leukomalacia. There were statistically significant differences between the different types of CWMD （P<0.05）. （2） Within the first two weeks of white matter damage, DWI had high sensitivity. There were 98% characterized by high signal. T1WI also showed normal or slightly high signals, with or without low signals on T2WI. High signal on DWI of focal CWMD can last for more than 3 weeks, but diffuse CWMD had short duration （within 2 weeks）. （3） Focal CWMD often only involved one site of damage （65.3%）, mainly concentrated in the lateral ventricle hind feet （53.5%）. Widespread CWMD often involved corpus callosum and internal capsule （79.2%）, and diffuse CWMD often combined gray matter injury, accounting for 50.0%. （4） There were well correlations in damage type and the infants neurological development result. 1-3 weeks to review after damage, there were 97.1% of focal CWMD characterized by disappearing or decreasing of the lesion range. They often had normal or slightly high signal on DWI, high T1WI signal, with or without high T2WI signal. But the diffuse CWMD all developed into PVL, characterized by high T2WI signal and low signal on T1WI and DWI. Conclusion We should do MRI and DWI for the high-risk late preterm infants within 2 weeks after birth, in order to detect the damage as soon as possible. The prognosis of focal CWMD was good. However, the infants suffered from diffuse CWMD had so poor prognosis that they need follow up dynamically and receive early suitable recovery as soon as possible.
冯子鉴 陈丹 张静 王晓明 李娟 毛健. 应用DWI结合常规MRI动态评价晚期早产儿脑白质损伤[J]. 发育医学电子杂志, 2014, 2(1): 6-12.
FENG Zi-jian, CHEN Dan, ZHANG Jing, et al. To evaluate cerebral white matter damage in the late preterm infants by DWI combined with conventional MRI. Journal of Developmental Medicine(Electronic Version), 2014, 2(1): 6-12.
2014, Vol. 2 
