新生儿缺氧缺血性脑病与急性胆红素脑病的MRI诊断及鉴别  

MRI in Diagnosis and Differential Diagnosis of Hypoxic-ischemic Encephalopathy

作　　者：黄文雅[1] 陈桦[1] 周晶[1] 王海[1] 伍光春[1] 金科[1] 

机构地区：[1]湖南省儿童医院放射科,湖南长沙410007

出　　处：《医学临床研究》2011年第11期2112-2115,共4页Journal of Clinical Research

摘　　要：【目的】探讨常规磁共振成像（MRI）和扩散加权成像（DWI）鉴别新生儿缺氧缺血性脑病（HIE）与急性胆红素脑病的价值。【方法】回顾性分析伴有基底节累及的HIE新生儿28例和急性胆红素脑病新生儿患者30例的常规MRI及DWI特点。【结果】在T1WI上，HIE患儿苍白球和底丘脑高信号的出现率分别为35．7％（10／28）和14．2（4／28），显著低于急性胆红素脑病93．3％（28／30）和53．3％（16／30）（P〈0．01）；HIE惠儿壳核和背侧丘脑高信号的出现率分别为64．2％（18／28）和64．2％（18／28），显著高于急性胆红素脑病患儿0．0％和30．0％（9／30）（Pd0．01）。在DWI上，25例HIE患儿基底节出现高信号，而急性胆红素脑病患儿均无基底节异常信号。【结论】常规MRI及DWI有助于新生儿HIE和急性胆红素脑病的诊断与鉴别诊断。[Objective] To explore the clinical value of conventional magnetic resonance imaging（MRI） and diffusion weighed imaging（DWI） in differential diagnosis of hypoxic-ischenic encephalopathy（HIE） and acute bilirubin encephalopathy. [Methods]The features of conventional MRI and DWI in 28 neonates with HIE involving basal ganglia and 30 neonates with acute bilirubin encephalopathy were retrospectively reviewed. [Results] On T1WI, the frequencies of hyperintensity in globus pallidus and subthalamus of pediatric patients with HIE were 35.7% （10/28） and 14.2% （4/28） respectively which were significantly lower than those in globus pallidus[93.3% （28/30）] and subthalamus[53.3 % （16/30）] of pediatric patients with acute bilirubin encephalopathy（ P d0.01）. The frequencies of hyperintensity in putamen and dorsalthalamus of pediatric patients with HIE were 64.2% （18/28） and 64.2% （18/28） respectively which were significantly higher than those in putamen（0.0 %） and dorsalthalamus[30.0% （9/30）] of patients with acute bilirubin encephalopathy group（ P 〈0.01）. On DWI, 25 pediatric patients with HIE presented hyperintensity signal in basal ganglia, while all 26 pediatric patients with acute bilirubin encephalopathy presented no abnormal signal in basal ganglia. [Conclusion] Conventional MRI and DWI are useful in diagnosis and differential diagnosis of HIE and acute bilirubin encephalopathy in neonates.

关 键 词：脑缺血/诊断 脑缺氧/诊断 磁共振成像 诊断 鉴别 

分 类 号：R743.31[医药卫生—神经病学与精神病学]