新生儿缺氧缺血性脑病的磁共振弥散张量成像及动脉自旋标记技术的诊断价值研究  

Study of diffusion tensor imaging and arterial spin labeling in diagnostic and grading value of hypoxic ischemic encephalopathy

作　　者：邢可舟 孔晓勤 葛亚平[1] 郭文彬[1] 郑应心 史浩[1] 

机构地区：[1]山东省千佛山医院影像科,济南250014

出　　处：《中华脑科疾病与康复杂志（电子版）》2016年第1期37-41,共5页Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）

基　　金：山东省医药卫生科技发展计划项目(2011WSB04016)

摘　　要：目的探讨弥散张量成像（DTI）技术及动脉自旋标记成像（ASL）技术对新生儿缺氧缺血性脑病（HIE）的诊断、分度价值及其与临床分度的相关性。方法选取16例临床上诊断为HIE的足月新生儿作为HIE组,14例无窒息病史及其他神经系统疾病的足月新生儿作为正常组,HIE组及正常组均进行常规MRI（T1WI、T2WI、T2-FLAIR、DWI）及磁共振波谱成像（MRS）扫描,两组均进行DTI、ASL扫描。经Siemens工作站软件处理后,观察DTI图像及ASL灌注图像,对HIE组及对照组的感兴趣区（双侧基底节、丘脑、额叶、顶叶）进行各参数测定,运用t检验进行组间比较。结果 HIE组各感兴趣区的各向异性分数（FA）、相对各向异性（RA）值较对照组均降低,容积比（VR）及基底节区相对脑血流量（r CBF）值均升高,差异具有统计学意义（P〈0.05）,两组间白质区r CBF值差异无统计学意义（P〉0.05）,随着HIE严重程度的增加,各感兴趣区的FA值不同程度减低,基底节及丘脑的r CBF不同程度增加,差异具有统计学意义（P〈0.05）,通过卡方检验,基底节FA值、基底节及丘脑r CBF的HIE发现率及严重程度分级与临床一致（χ^2值分别为22.71、25.28,P〈0.001）。结论 DTI及ASL技术对HIE的诊断及判断其严重程度有重要价值,且其分度与临床分度一致。Objective To discuss the diagnostic and the grading value of diffusion tensor imaging （DTI） and arterial spin labeling （ASL）in hypoxic ischemic encephalopathy （HIE）, and to assess the consistency of these two sequences＇ grading and clinical grading. Methods Sixteen full-term neonates which clinically diagnosed as HIE were selected as HIE group, and fourteen full-term neonates without any nervous system diseases were chosen as normal group. All cases underwent routine MR（ T1WI, T2WI, T2-FLAIR, DWI）and MRS scan. All cases were performed DTI and ASL scan, which were processed by Siemens workstation. The parameter values of both groups were measured on bilateral basal ganglia, thalamus, frontal white matter and parietal white matter, and the mean value were calculated and compared by using t test between groups. Results The fractional anisotropy （FA） and relative anisotropy （RA） value of region of interest（ROI） were lower in HIE group than that in control group, the volume ratio （VR）value of ROI and the relative cerebral blood flow （rCBF） value of the basal ganglia were higher in HIE group than that in control group, the differences were statistically significant（ P 〈 0. 05 ）. And there was no significant difference in the rCBF value of the white matter （ P 〉 0. 05 ）. With the increase of HIE severity, the FA values of different degree HIE were reduced, and the rCBF values of different degree HIE of the basal ganglia and thalamus were increased. The differences were statistically significant （ P 〈 0. 05 ）. By Chi-square test, the abnormal detection rate of the FA value of the basal ganglia and the rCBF value of the basal ganglia and thalamus were consistent with clinical grading （X^2 values were 22. 71,25.28, respectively, P 〈 0. 001 ）.Conclusion It is helpful to diagnoze HIE and determine its severity by DTI and ASL technology, and its grading value is consistent with clinical grading value.

关 键 词：缺氧缺血 脑 磁共振波谱学 磁共振成像 弥散 婴儿 新生 动脉自旋标记 

分 类 号：R445.2[医药卫生—影像医学与核医学]