MRI与CT影像诊断新生儿缺氧缺血性脑病脑损伤程度的价值  

The value of MRI and CT imaging in the diagnosis of brain injury in newborns with hypoxic-ischemic encephalopathy

作　　者：朱振国[1] 姜熳[1] 孙赟[1] 周晓光[2] 邹芸苏[2] 郭雪梅 ZHU Zhen-Guo;JIANG Man;SUN Yun(Jiangsu Provincial Hospital of Traditional Chinese Medicine,Nanjing,Jiangsu 210029,China)

机构地区：[1]江苏省中医院,江苏南京210029 [2]南京医科大学附属儿童医院,江苏南京210000

出　　处：《中国妇幼保健》2018年第21期4981-4984,共4页Maternal and Child Health Care of China

基　　金：江苏省临床医学科技发展计划项目(BL2012018)

摘　　要：目的探讨磁共振成像(MRI)与电子计算机断层扫描(CT)影像诊断对新生儿缺氧缺血性脑病脑损伤程度的价值。方法选择2015年7月-2017年7月该院接诊的70例缺氧缺血性脑病新生儿为研究对象,均有明确窒息史,根据临床症状表现,轻度52例,中度16例,重度2例,所有患儿于出生后1～10d内同步进行MRI、CT检测,比较两种方式对新生儿缺氧缺血性脑病脑损伤程度的评估价值以及病变检出率。结果以临床表现作为诊断标准,MRI检出率为100. 00%(70/70),其中轻度符合率为61. 53%(32/52),中度符合率为75. 00%(12/16),重度符合率为100. 00%(2/2); CT检出率为91. 43%(64/70),轻度符合率为46. 15%(24/52),中度符合率为62. 50%(10/16),重度符合率为100. 00%(2/2); MRI检出率明显高于CT检出率(P<0. 05); MRI脑水肿、脑室出血、基底核丘脑损伤、矢状旁区损伤、脑动脉梗死的总检出率为98. 57%(69/70),CT病变总检出率为85. 71%(60/70),经比较差异均具有统计学意义(P<0. 05)。结论 MRI、CT影像分度对缺氧缺血性脑病患儿均具有较好的诊断价值,而MRI更有助于评价脑损伤程度及病变区域的检查,但MRI价格较为昂贵,临床检查中可先使用CT辅助检查,若结果和临床诊断差异较大,则再行MRI检查,以提高疾病早期诊断率。Objective To study the value of MRI and CT imaging in the diagnosis of brain injury in newborns with hypoxic-ischemic encephalopatby. Methods 70 newborns of hypoxic-ischemic encephalopathy were selected as research objects. According to the clinical symptoms, 52 cases were mild, 16 cases were moderate, and 2 cases were severe. All the cases were synchronized detected with MRI and CT in 1 - 10d after birth, the value of the two methods in evaluating the degree of brain injury in neonates with hypoxic-ischemic encepha- lopathy and the detection rate of pathological changes were compared. Results The clinical manifestations as diagnostic criteria, the detec- tion rate of MRI was 100% （70/70）, the coincidence rate of mild coincidence rate was 61.53% （32/52）, the moderate coincidence rate was 75% （ 12/16）, and the severe coincidence rate was 100% （2/2） ; the detection rate of CT was 91.43% （64/70）, the mild coinci- dence rate was 46. 15% （ 24/52 ） , the moderate coincidence rate was 62. 50% （ 10/16 ）, and the severe coincidence rate was 100% （2/2） ; the detection rates of MRI were significantly higher than those of CT（ P〈0. 05 ） ; the total detection rate of MRI brain edema, ventri- cle hemorrhage, basal nucleus and thalamus injury, parasagittal area injury, cerebral artery infarction was 98. 57% （69/70）, the total detec- tion rate of CT lesions was 85.71% （60/70）, there was significant difference in comparison （P〈0. 05 ）. Conclusion MRI, CT image inde- xing have good value to the diagnosis of hypoxic ischemic encephalopathy, and MRI is helpful to evaluate the degree of brain injury and the lesion examination, but MRI is more expensive. In clinical examination, CT auxiliary examination can be used first, and if the difference be- tween the results and clinical diagnosis is great, then MRI examination can be performed to improve the rate of early diagnosis of disease.

关 键 词：新生儿缺氧缺血性脑病 脑损伤程度 磁共振成像 电子计算机断层扫描 

分 类 号：R722.1[医药卫生—儿科]