足月新生儿缺氧缺血性脑病的磁共振扩散张量成像研究  

Assessment of Hypoxic Ischemic Encephalopathy in Term Infants by Using Diffusion Tensor Imaging

作　　者：王剑[1] 漆剑频[1] 石晶晶[1] 常立文[2] 张顺[1] 郭林英[1] 朱文珍[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院放射科,武汉430030 [2]华中科技大学同济医学院附属同济医院新生儿科,武汉430030

出　　处：《临床放射学杂志》2016年第7期1083-1087,共5页Journal of Clinical Radiology

基　　金：国家"十二五"科技支撑计划项目(编号:2011BAI08B10);国家自然科学基金资助项目(编号:81171308)

摘　　要：目的评价3.0 T MR扩散张量成像(DTI)在足月新生儿缺氧缺血性脑病(HIE)中的应用价值。方法以19名无窒息史的正常足月新生儿做为对照,对24例HIE患儿(轻度19例、中重度5例)进行常规MRI及DTI检查。选取双侧大脑脚、豆状核、内囊后肢前后部、丘脑、半卵圆中心层面额叶前后部、顶叶以及胼胝体膝部、压部为感兴趣区(ROI),分别测得分数各向异性(FA)、平均扩散系数(MD)、轴向扩散张量(λ//)、垂直扩散张量(λ⊥)。采用ANOVA分析三组间不同部位各参数的变化。结果轻度组胼胝体压部FA值及左侧大脑脚MD、λ//值较对照组降低(P<0.05)。中重度组皮质脊髓束走行区、胼胝体膝部及压部的FA、λ//较对照组明显降低(P<0.001)。另外,中重度组左侧大脑脚λ⊥较对照组降低,而左侧内囊后肢前部、双侧内囊后肢后部λ⊥较对照组升高(P<0.01)。结论 DTI更能反映不同程度HIE损伤后脑组织轴索、髓鞘细微结构的改变。Objective To investigate the application of Diffusion Tensor Imaging（ DTI） in assessing the brain damage of hypoxic ischemic encephalopathy（ HIE） in term infants. Methods 43 infants（ 24 term HIE infants and 19 term controls） underwent conventional MR and Diffusion Tensor Imaging on a 3. 0T MRI system. Ethical approval for this study was granted by the institutional review board,and informed parental consent was obtained for each infant. 24 HIE infants were divided into two groups based on their clinical manifestations and conventional MR findings： mild HIE group（ 19 infants）and moderate-severe HIE group（ 5 infants）. We chose bilateral cerebral pedunces（ CP）,lentiform nucleus（ LN）,anterior and posterior of posterior limbs of internal capsule（ PLIC）,thalamus（ TH）,anterior and posterior of frontal white matter and the parietal white matter at the semiovale center level（ FWMa,FWMp,PWM respectively）,the genu and splenium of corpus callosum（ GCC and SCC respectively） as ROIs. Then FA、MD、axial diffusivities（ λ//） and radial diffusivities（ λ⊥） values were measured in the above ROIs. The differences among these three groups were analyzed via one-way analysis of variance（ ANOVA）. Results The FA value at the splenium of corpus callosum and the MD、λ// value at the left CP was lower than control group in the Mild group（ P〈0. 05）. The FA 、λ// values of the moderate-severe group at the corticospinal tracts,the genu and splenium of corpus callosum were lower than control group（ P〈0. 001）. In the moderate-severe group,the λ⊥ value of the left CP was lower than control group,while λ⊥ values at the anterior of the left PLIC,and the posterior of bilateral PLIC were higher than control group（ P〈0. 01）. Conclusion DTI is a useful tool to detect the microstructural changes of axon and myelin sheath of brain damage in neonatal hypoxic1 ischemic encephalopathy.

关 键 词：新生儿 缺血缺氧性脑病 扩散张量成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]