DWI对重度HIE早期诊断及预后评价的价值研究  

DWI in severe HIE in early diagnosis and prognostic value in research

作　　者：张丽丽[1,2] 

机构地区：[1]山东大学省立医院 [2]聊城市东昌府人民医院,山东聊城252000

出　　处：《中国地方病防治》2016年第2期147-149,共3页Chinese Journal of Control of Endemic Diseases

摘　　要：目的探讨核磁共振弥散加权成像(DWI)在重度新生儿缺氧缺血性脑病(HIE)早期诊断以及预后评价中的价值。方法 2013年1月~2015年1月,本院收治12例重度HIE患儿,均于出生后3d内行常规MRI和DWI扫描。同时对12例患儿的6个大脑区域行(表观弥散系数)ADC值测量,以同期住院的12例无神经系统疾病的足月儿为对照。6个大脑区域分别为内囊后肢、基底节区、腹外侧丘脑区、枕叶皮层、脑干和额叶皮层。结果 MRI扫描结果显示:12例重度HIE患儿3d内MRI仅2例患儿T2WI可见部分皮层信号稍微变高,余未见其他异常。DWI扫描结果显示:12例患儿均可见异常高信号,其中4例患儿出现双侧腹外侧丘脑区和基底节区异常高信号,同时有3例患儿还伴有内囊后肢和脑干信号异常;2例患儿出现双侧腹外侧丘脑区和枕叶皮层信号异常;2例患儿出现单纯双侧腹外侧丘脑区信号异常;1例患儿出现枕叶皮层和额叶皮层的信号异常。两组患儿ADC值的比较,HIE组患儿的内囊后肢、基底节区、腹外侧丘脑区、枕叶皮层、脑干和额叶皮层着6个区域的ADC值高于对照组,差异有统计学意义(P<0.05)。重度HIE组患儿预后均较差,其中伴有内囊后肢和脑干信号异常的患儿预后更差。结论在重度HIE患儿脑损伤的早期检测及预后评估方面,DWI检查比常规MRI更加敏感,可较早的反映缺氧缺血性脑损伤并对患儿的预后做出很好的预测,有着重要的临床应用价值。Objective To study the diffusion-weighted magnetic resonance imaging(DWI)in severe hypoxic-ischemic encephalopathy(HIE)in early diagnosis injury and prognstic.Methods January 2013~January 2015 period,our hospital in children with severe HIE 12 cases were in line three days after the birth of a conventional MRI and DWI scans.While 12 cases of brain regions in children 6rows(apparent diffusion coefficient)ADC values measured in term children hospitalized with the same period 12 patients without neurological disease as a control.Six brain regions were limb of the internal capsule,basal ganglia,the ventrolateral thalamus,occipital cortex,brainstem and frontal cortex.Results MRI scans showed:12cases of infants with severe HIE 3days,only 2patients MRI T2 WI slightly visible part of the cortex signal goes high,it was no other abnormalities.DWI scans showed:12cases were seen in children with abnormal high signal in which five cases of children with bilateral ventrolateral thalamus and basal ganglia abnormal high signal,while 3patients accompanied limb of the internal capsule,and brain stem signal abnormalities;2patients with bilateral ventrolateral thalamus and occipital cortex signal abnormality;two cases of children with purely bilateral ventrolateral thalamus signal abnormalities;one cases of children with occipital cortex and prefrontal cortex signal abnormal.ADC values between the two groups of children,children with HIE group within handers,basal ganglia,thalamus ventrolateral region,occipital cortex,brainstem and frontal cortex of the ADC value higher than six regions,the difference there was statistically significant(P<0.05).The prognosis of severe HIE group were poor,which accompanied by limb of the internal capsule and brainstem abnormalities in children signal a worse prognosis.Conclusion In the early detection and prognosis of children with severe HIE brain injury aspect,DW I check more sensitive than conventional MRI,may reflect the earlier hypoxicischemic brain injury and prognosis of children make a good p

关 键 词：核磁共振弥散加权成像 新生儿缺血缺氧性脑病 表观弥散系数 

分 类 号：R445.2[医药卫生—影像医学与核医学] R742[医药卫生—诊断学]