脑室周围白质软化早产儿出生早期MRI表现及其演变  

Early MRI performance and the evolution of premature infants diagnosed with periventricular leucomalacia

作　　者：刘子云[1] 富建华[1] 薛辛东[1] 

机构地区：[1]中国医科大学附属盛京医院新生儿科,沈阳110004

出　　处：《中国小儿急救医学》2014年第4期220-224,共5页Chinese Pediatric Emergency Medicine

摘　　要：目的 探讨最终发展为脑室周围白质软化（periventricular leucomalacia,PVL）的早产儿出生早期头部MRI表现及其演变.方法 选取2010年1月至2013年12月中国医科大学附属盛京医院新生儿科住院经MRI确诊为PVL的患儿12例,所有病例均在生后2～7d（平均5.5d）及17～23 d（平均20.3 d）完成2次常规MRI及弥散加权成像（diffusion-weighted imaging,DWI）扫描.结果 最终被确诊的12例PVL患儿,初次扫描结果：全部病例DWI显示脑室周围白质高信号,其中6例弥漫、对称性高信号,3例线状高信号,3例簇状高信号,而常规MRI仅有5例显示T1加权像稍高信号,T2加权像稍低信号,余7例无改变;再次扫描结果：全部患儿脑室周围白质出现大小不等、数量不一的病灶,常规MRI显示T1加权像低信号,T2加权像高信号,相应病变部位DWI呈低信号.结论 早产儿出生早期,DWI对发现和预测PVL优于常规MRI;弥漫性脑白质损伤易发展为PVL,较严重的局灶性脑白质损伤,如多簇状、线状损伤也有发展成PVL的可能.Objective To investigate the early MRI performance and the evolution of premature infants who developed into periventricular leucomalacia （PVL） eventually. Methods Twelve premature infants diagnosed as PVL by MRI in the department of neonatology in Shengjing Hospital of China Medical University from Jan 2010 to Dec 2013 were selected,all of the cases underwent conventional MRI and diffu- sion-weighted imaging （DWI） examination twice,the first examinations were finished in 2 to 7 days（ mean 5.5 d） after birth and the second examinations were taken in 17 to 23 days（ mean 20. 3 d）. Results The first examination showed：all cases performed high signal intensity of periventricular matter, including 6 diffuse and symmetrical,3 linear and 3 clustered high signal. However, only 5 of the 12 cases showed slightly high signal on T1 weighted image with low signal on T2 weighted image on conventional MRI, the other 7 cases showed no change; for the reexamination： foci of different numbers and sizes showed up in all cases, with the performance of low signal on T1 weighted image, high signal on T2 weighted image and low signal on DWI correspondingly. Conclusion DWI is superior to conventional MRI in finding and forecasting PVL;diffuse white matter damage have more probability to develop into PVL, severe local white matter damage such as multi-clustered and linear damage also can develop into PVL.

关 键 词：磁共振成像 脑室周围白质软化 弥漫性脑白质损伤 局灶性脑白质损伤 早产儿 

分 类 号：R742[医药卫生—神经病学与精神病学]