Intelligence Development Assessment And Cerebral Glucose Metabolism In Children With Congenital Heart Disease

Objective:To explore the mechanisms of blood dynamics and hypoxemia on intelligence development and cerebral glucose metabolism in children with congenital heart disease.Methods:1.79 cases eligibly children were selected for intelligence assessment and 41 cases eligibly children were selected for cerebral glucose metabolic rate examination,who hospitalized in department of pediatrics and cardiothoracic surgery of Affiliated Hospital of Southwest Medical University,from March to December in 2015.79 Children for intelligence assessment were divided into cyanotic group?29 cases?and acyanotic group?50 cases?.Children for cerebral metabolic examination were divided into control group?13 cases?,cyanotic group?19 cases?and acyanotic group?9 cases?.2.Intelligence assessment:Using the intelligence project of 0⁶ years old Developmental Screening Test?DST?Table respectively screen mental development of children with cyanotic or acyanotic congenital heart disease.Quantitative and qualitative analysis?normal,suspicious and abnormal?based on the assessment results.3.Cerebral glucose metabolic examination:Using 18F-fluorodeoxyglucose?18F-FDG?PET/CT examination to measure the maximum glucose average standard uptake value(SUV_max)of the frontal lobe,temporal lobe,parietal lobe,occipital lobe,the basal ganglia,thalamus,brainstem and cerebellum.Quantitative analysis based on the examination results.Results:1.Intelligence assessments:MI of 29 cases with cyanotic congenital heart disease was observed,among which 10 children's MI were abnormal?34.48%?,11 children's MI were suspected?37.93%?and 8 children's MI were normal?27.59%?.While among MI of 50 cases with acyanotic congenital heart disease,4 children's MI were abnormal?8.00%?,6 children's MI were suspicious?12.00%?and 40 children's MI were normal?80.00%?.Cyanotic and acyanotic group MI quantitative and qualitative differences were statistically significant?p=0.000 for each?respectively.2.Cerebral glucose metabolic examination:Brain CT scan of three groups showed no obvious abnormal density,and the left and right side of the corresponding area SUV_max ratios in all brain regions were close to 1,the difference was not statistically significant?p>0.05 for each?.SUV_max of each brain regions in control group were increasing with age.Children's brain regions SUV_max in each group were highest in frontal lobe,temporal lobe,parietal lobe,occipital lobe,followed by the thalamus,basal ganglia and cerebellum,lowest in brainstem.SUV_max of control group and cyanotic group children in the frontal lobe?p=0.041?and occipital lobe?p=0.044?,difference was statistically significant.However,there was no statistically significant in the temporal lobe,parietal lobe,the basal ganglia,thalamus,brainstem and cerebellum?p>0.05 for each?.Differences in children's brain tissue SUV_max of each brain region were not statistically significant between control group and acyanotic group,cyanotic group and acyanotic group?p>0.05 for each?.The ratio of the brain to brainstem SUV_maxax in the control group is higher than that in cyanotic and acyanotic group.Children in control and cyanotic group,whose ratio of the brain SUV_max to brainstem SUV_max was statistically significant differences in the frontal lobe?p=0.037?,parietal lobe?p=0.048?and occipital lobe?p=0.039?,but was no statistically significant differences in the temporal lobe,basal ganglia,thalamus,brainstem and cerebellum?p>0.05 for each?.The ratio of brain to brainstem SUV_max in each brain regions was no statistically significant differences between control group and acyanotic group,cyanotic group and acyanotic group?p>0.05 for each?respectively.Conclusion:Children with cyanotic congenital heart disease and acyanotic congenital heart disease are more vulnerable to abnormal MI compared with control.Glucose metabolic rates of children with congenital heart disease of the left and right brain are nearly equal.Normal children cerebral glucose metabolism rate gradually increased with age,and glucose metabolic rate of the frontal lobe and occipital lobe in children with cyanotic congenital heart disease is lower than normal children.Before the school age,brainstem may be used as a semi-quantitative analysis on the control of the brain region of interest.Hypoxemia in children with cyanotic congenital heart disease may be an important factor for children's intelligence and brain glucose metabolism abnormality.