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目的 通过多期动脉自旋标记(mTI-ASL)磁共振灌注成像技术,探讨围产期缺氧窘迫、感染对早产儿脑内各区域血流量的影响.方法 60例早产儿在36周＜矫正胎龄≤37周行常规磁共振检查及mTI-ASL磁共振灌注成像检查,共有50例早产儿最终被纳入本研究并分为4组:围产期正常组14例、围产期缺氧窘迫组12例、围产期感染组12例、围产期缺氧窘迫伴感染组12例,4组早产儿分别测定基底节及丘脑(BGT)、脑灰质(GM)、脑白质(WM)区域的脑血流量(CBF),同时,脑灰质区域分别测定额叶、颞叶、枕叶的CBF,各组间数据先行单因素方差分析,当P ＜0.05时,再行样本均数两两比较的q检验(SNK法),α=0.05作为检验标准.结果 在BGT区域,围产期正常组分别与感染组、缺氧窘迫伴感染组比较,缺氧窘迫组与感染组比较CBF差异有统计学意义(P＜0.05);缺氧窘迫组与缺氧窘迫伴感染组比较CBF差异有统计学意义(P＜0.01);在GM区域,围产期正常组分别与感染组、缺氧窘迫伴感染组比较,CBF差异有统计学意义(P＜0.05),缺氧窘迫组分别与感染组、缺氧窘迫伴感染组比较CBF差异有统计学意义(P＜0.01);在WM区域,四组CBF差异均无统计学意义.围产期正常组早产儿中,额叶与枕叶、颞叶与枕叶CBF差异有统计学意义,额叶与颞叶CBF差异无统计学意义;其他三组早产儿中,额叶、颞叶、枕叶局部CBF两两对比差异均无统计学意义.结论 mTI-ASL可以无创定量测定局部CBF,在新生儿脑血流动力学研究中优势明显;围产期感染将影响到早产儿深部灰质核团和皮层动脉血管生成;围产期缺氧窘迫和感染将会影响早产儿脑灰质CBF的区域性调控.“,”Objective To investigate the influence of cerebral blood flow in preterms with perinatal asphyxia and infection by multiple inversion time arterial spin labeling(mTI-ASL) technique.Methods A total of 60 preterms at term-equivalent age underwent MRI examination.The MRI examination including mTI-ASL prototype sequence and other conventional plain sequences were performed using MAGNETOM Skyra(Siemens Healthcare,Erlangen,Germany),and 50 preterm infants were enrolled in this study and divided into four groups:Group1 (n =14,perinatal normal),Group2 (n =12,perinatal asphyxia),Group3 (n =12,perinatal infection) and Group4 (n =12,perinatal asphyxia and infection).Mean cerebral blood flow (CBF) values from ROIs drawn in the basal ganglia and thalami (BGT),gray matter (GM) including frontal lobe,temporal lobe and occipital lobe,and white matter (WM) were calculated and analyzed by SPSS 21.0 statistical software.CBF values for each ROIs were analyzed by one-way ANOVA across groups.And then if P ＜ 0.05,q test for multiple comparison with SNK was analyzed.Results The difference of CBFBGT was statistically significant between Group1 and Group3,between Group1 and Group4,between Group2 and Group3 (P ＜ 0.05),between Group2 and Group4 (P＜0.01).The differences of CBFGM was statistically significant between Group1 and Group3,between Group1 and Group4 (P ＜0.05),between Group2 and Group3,between Group2 and Group4 (P ＜ 0.01).However,the difference of CBFWM between any two groups was not statistically significant.On the other hand,in group1,the difference of CBF was statistically significant between frontal lobe and occipital lobe,between temporal lobe and occipital lobe,whereas the difference of CBF was not statistically significant between frontal lobe and temporal lobe.Conclusion mTI-ASL is a noninvasive MR method for accurately measuring CBF in neonates.Angiogenesis in BGT and GM will be decreased in preterms with perinatal infection.Both perinatal asphyxia and infection may affect the regional regulation of CBF in gray matter.