FA值在新生儿缺氧缺血性脑病随访中的应用  

FA Values on Infants Born at Term with Hypoxic-Ischemic Encephalopathy

作　　者：沈全力[1] 冯晓源[1] 钱镔[2] 

机构地区：[1]复旦大学附属华山医院放射科,上海200040 [2]复旦大学附属儿科医院放射科,上海200040

出　　处：《中国医学计算机成像杂志》2009年第2期158-163,共6页Chinese Computed Medical Imaging

摘　　要：目的:探讨FA值在新生儿缺氧缺血性脑病(HIE)随访中的价值。方法:对28例出生时诊断为HIE的儿童行DTI检查,并和对照组比较,分析脑不同部位的FA值和病变程度及发育商(DQ)的相关性。结果:轻度HIE9例,中度HIE13例,重度HIE6例。DQ随HIE病情的加重而减低(P<0.05)。病例组大脑半球多个白质区域的FA值减低,且随病情加重而降低(P<0.05)。内囊后肢的FA值在HIE轻、中、重度各组中和原发病变的轻重均存在相关性(P<0.05)。病例组FA值和DQ的相关性方面,重度HIE组和轻度HIE组间具有相关性的区域最多、程度最大,中度HIE组和重度HIE组间具有相关性的区域减少、程度减低,中度HIE组和轻度HIE组间的绝大部分区域无相关性。结论:在HIE患儿随访中FA值能定量地反映原发病变的轻重。但患儿的智能运动发育情况受康复治疗的影响变化较大,尤其是中度HIE患儿,在用FA值评估其预后时需与临床资料结合综合分析。Purpose： To evaluate the role of fractional anisotropy（FA） values on infants born at term with hypoxicischemic encephalopathy（HIE）. Methods： Twenty- eight infants who were born at term, diagnosed with HIE were investigated with diffusion tensor imaging. Clinical references, developmental quotient（DQ） and FA values were used as a basis of comparison to a group of controls with the same age and gender distribution. Results： Of the 28 cases, 9 were mild HIE, 13 were moderate HIE, 6 were severe HIE. Correlation existed between DQ and the degree of HIE（P 〈 0.05） . In several cerebral white matter areas, FA values were lower in the group of individuals with a history of HIE, and in line with the degree of HIE（P 〈 0.05）. Obvious correlation existed between the FA values in posterior limb of internal capsule and the degree of HIE（P 〈 0.05） . Between severe HIE group and mild HIE group, FA values in most cerebral white matter areas were correlative with DQ. Between moderate HIE group and severe HIE group, FA values in some cerebral white matter areas were correlative with DQ. Between moderate HIE group and mild HIE group, FA values of most cerebral white matter areas were no correlation with DQ. Conclusion： FA values can quantitatively reflect the degree of HIE. But the developmental status of patients is affected by rehabilitation therapy, especially in moderate HIE group. Combining FA values with clinical references to evaluate their prognosis is necessary.

关 键 词：缺氧缺血性脑病 弥散张量成像 分数各向异性 发育商 

分 类 号：R722.1[医药卫生—儿科]