表观扩散系数直方图评估先天性心脏病新生儿的脑改变  

Brain alteration in neonates with congenital heart disease using apparent diffusion coefficient histograms

作　　者：朱美娇 王颖 李慧君[1] 杨明[1] 莫绪明[2] 程锐[3] 王树杰 孙炜航 孙钰[4] Zhu Meifiao;Wang Ying;Li Huijun;Yang Ming;Mo Xuming;Cheng Rui;Wang Shujie;Sun Weihang;Sun Yu(Department of Radiology,Children＇s Hospital of Nanfing Medical University,Nanjing 210008,China)

机构地区：[1]南京医科大学附属儿童医院放射科,210008 [2]南京医科大学附属儿童医院心胸外科,210008 [3]南京医科大学附属儿童医院新生儿科,210008 [4]东南大学生物科学与医学工程学院

出　　处：《中华医学杂志》2018年第39期3162-3165,共4页National Medical Journal of China

基　　金：江苏省妇幼保健科研项目（F201554）;南京市科技发展项目（2015se511023）;江苏省“六大人才高峰”项目（WSN-192）;南京医科大学科技发展基金面上项目（2015NTIUU080）

摘　　要：目的评价表观扩散系数（ADC）直方图对先天性心脏病（CHD）新生儿脑改变的诊断价值。方法收集2012年1月至2016年12月南京医科大学附属儿童医院经心脏超声证实的间隔缺损型CHD新生儿的脑磁共振（MR）资料60例（CHD组），新生儿肺炎或头皮血肿疑有颅内病变但MR正常的新生儿脑MR资料22例（对照组）。采用MRIcron及ImgJ软件获得直方图及参数。分别计算两组孕龄与各参数值的相关性，采用t检验分析两组参数值的差异，受试者工作特征曲线分析诊断效能。结果除ADC均值、ADC最小值、ADC峰值外，两组各参数值与孕龄呈显著相关（P〈0.05），70th～95th ADC值、偏度、峰度及方差在两组间差异有统计学意义（t＝2.01、2.25、2.31、2.49、2.58、2.73、-2.05、-2.16、2.54，P〈0.05）。90th ADC值的曲线下面积最大，为0.698。结论ADC直方图可量化、客观地提供脑组织更多的扩散信息，是识别CHD新生儿脑改变的一种快速可行的定量分析方法。ObjectiveTo evaluate the value of apparent diffusion coefficient （ADC） histogram in neonatal brain alteration with congenital heart disease （CHD）.MethodsMRIs of 60 neonates with CHD confirmed by echocardiography were retrospectively analyzed in Children′s Hospital of Nanjing Medical University from January 2012 to December 2016.Twenty-two MRIs of neonates with mild pneumonia or scalp hematoma who were suspicious of brain disease but normal MRI findings were enrolled as normal control.MRIcron and ImgJ softwares were used to acquire ADC histogram.The correlation between the gestational age and ADC histogram values were calculated respectively.Then t-test was used to analyze the differences of the histogram values and the diagnostic efficacy of different parameters was analyzed using the receiver operating characteristic curve.ResultsThe ADC values were significantly correlated with the gestational age （P〈0.05）. The 70th-90th ADC, skewness, kurtosis and variance were statistically significant （P〈0.05）. The area under the curve of the 90th ADC value was the largest at 0.698.ConclusionsThe ADC histogram can quantify and objectively provide more diffusion information of brain tissue. It is a rapid and feasible quantitative method to identify brain changes in neonates with CHD.

关 键 词：心脏病 婴儿 新生 磁共振成像 扩散 

分 类 号：R725.4[医药卫生—儿科] R445.2[医药卫生—临床医学]