应用ADC值对新生儿缺氧缺血性脑病追踪复查的初步研究  

The Role of ADC Values in Evaluating Follow-Up Value of Neonatal Hypoxic-Ischemic Encephalopathy:Initial Experience

作　　者：左克扬[1] 罗学毛[1] 龙晚生[1] 刘斯润[2] 

机构地区：[1]广东省江门市中心医院放射科,广东江门529030 [2]暨南大学附属第一医院影像中心,广东广州510632

出　　处：《中国CT和MRI杂志》2011年第4期20-22,64,共4页Chinese Journal of CT and MRI

摘　　要：目的应用磁共振弥散张量成像定量测定ADC值,探讨ADC值在随访复查婴幼儿期缺氧缺血性脑病(HIE)中的应用价值,揭示HIE影响患儿脑髓鞘发育及预后状况的特征。方法追踪复查45例6-30个月婴幼儿期足月HIE患儿,依据新生儿期初查时临床表现分为轻度、中度和重度三组进行DTI检查,测定三组患儿相同感兴趣区的表观弥散系数(ADC)值。结果 ADC值在胼胝体压部、内囊后肢、放射冠、额叶白质、顶叶白质、豆状核各个感兴趣区的组间差异均有统计学意义;除豆状核外,ADC值随病情加重而升高。结论磁共振弥散张量成像的ADC值,在HIE追踪复查中可定量反映新生儿期不同轻重程度HIE患儿脑损伤对不同时期脑白质髓鞘发育的影响度,较常规磁共振成像评价更为早期、准确、客观、敏感;为HIE患儿脑损伤程度提供了有价值的监测指标。对新生儿缺氧缺血性脑病的病情评估具有重要意义。Objective To determine the utility of using quantitative diffusion isotropy value as an objective means of detection infants who suffered from hypoxic-ischemic encephalopathy（HIE） in full-term neonatal period. In order to evaluate the follow-up value of ADC value on full-term HIE. Methods Conventional MR images and quantitative diffusion tensor MR images from 45 infants who had clinically diagnosed HIE before, including 20 cases of mild type, 16 cases of moderate type,9 cases of severe type. Apparent diffusion coefficient（ADO） value was calculated in predefmed regions in the three groups. A one-way ANOVA（analysis of varriance） was performed to compare ADC value among the groups for each region. Results ADC values of the three groups were significantly different in regions of intresting（ROIs）：splenium of corpus callosum, posterior limb of internal capsule, corona radiate,front white matter, parietal white matter and putamina nuclei.ADC values increased by the order of ascending degree of HIE except putamina nuclei. Conclusion Quantitative diffusion tensor of isotropy values can improve conspicuity than conven- tional MRI images and provide an objective measure of hypoxic-ischemic injury on myelination of white matters.Calculation of isotropy values may provide a valuable marker index for the severity of hypoxic-ischemic injury.

关 键 词：缺氧缺血性脑病 婴幼儿 弥散张量 磁共振成像 各向同性 

分 类 号：R722[医药卫生—儿科] R445.2[医药卫生—临床医学]