磁共振弥散加权成像在新生儿缺氧缺血性脑病早期诊断中的临床应用价值  

Clinical application value of magnetic resonance diffusion weighted imaging in the early diagnosis of neonatal hypoxic ischemic encephalopathy

作　　者：鲁洪[1] 张来安[1] 郭玉君[1] 

机构地区：[1]四川省江油市人民医院放射科,四川江油621700

出　　处：《医学影像学杂志》2017年第5期797-800,共4页Journal of Medical Imaging

基　　金：四川省卫生厅科研课题项目(编号:20130461)

摘　　要：目的探讨磁共振弥散加权成像(DWI)在新生儿缺氧缺血性脑病(HIE)早期诊断的临床应用价值。方法收集本院经临床确诊为HIE共51例,临床分度:轻度28例,中度17例,重度6例,对所有患儿进行常规T1WI、T2WI和DWI扫描,b值=800s/mm^2,分析不同序列影像学表现,评价DWI在早期诊断HIE脑白质损伤的临床应用价值。结果常规T1WI+T2WI序列在HIE轻度、中度、重度组分别检出阳性19例、15例、6例,DWI序列分别检出阳性26例、17例、6例,常规T1WI+T2WI序列与DWI序列检出阳性率各为78.43%(40/51)、96.07%(49/51),P<0.05,差异有统计学意义。在51例HIE患儿中,共检出HIE病灶数目84个,常规T1WI+T2WI序列检出59个,DWI序列检出78个,病灶数目检出率分别为70.23%(59/84)、92.85%(78/84),P<0.05,差异有统计学意义。结论 DWI序列在早期诊断HIE及脑白质损伤病灶数目检出方面均高于常规T1WI、T2WI,是早期诊断HIE重要检测手段,对临床HIE早期诊断、早期干预治疗提供准确的客观依据。Objective To study the the clinical application value of magnetic resonance diffusion weighted imaging （DWI） in early diagnosis of neonatal hypoxic i-chemic encephalopathy （HIE）. Methods A total of 51 patients with HIE, who were diag- nosed by the clinic in our hospital, were collected in this work. Of those 51 cases, 28 cases were mild, 17 were moderate, and 6 were severe on the basis of clinical scale. All children with HIE underwent routine T1WI, T2WI and DWI scans, with b value = 800 s/b. Then, we analy the imaging findings of different sequence and evaluated the clinical value of DWI in the early diagnosis of cerebral white matter lesions of HIE. Results The conventional T1WI plus T2WI sequences positively detected that the patients with HIE in mild, moderate and severe groups were 19 cases, 15 cases, 6 cases, respectively. While, DWI sequence positively detected that the patients with HIE in corresponding groups were 26 cases, 17 cases, 6 cases, respectively. The positive rate by conventional T1WI ＋ T2WI sequences or DWI sequence was 78.43 % （40/51 ）, 96.07 % （49/51 ）, P 〈 0.05, the difference was statistically significant. In 51 children with HIE, a total of 84 lesions were detected. The conventional T1WI ＋ T2WI detected 59 and DWI sequence detect 78. The detection rate was 70.23% （59/84）, 92.85% （78/84）, P 〈0.05, the difference was statistically significant. Conclusion DWI sequence was superior to the conventional T1WI, T2WI in both the early diagnosis of HIE and the detection of the injury of cerebral white matter, which is important detection means for HIE, thereby providing the accurate and bjective basis for the early diagnosis and intervention of HIE.

关 键 词：磁共振成像 缺氧缺血性脑病 新生儿 

分 类 号：R742[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]