常规MRI和扩散张量成像在足月新生儿HIE的诊断价值  

Diagnostic value of MRI and diffusion tensor imaging in full-term neonates with hypoxic ischemic encephalopathy

作　　者：黄珍欢[1] 詹泽娟[1] 涂学招 何永红[1] 林祺[1] 杨健[2] HUANG Zhenhuan;ZHAN Zejuan;TU Xuezhao;HE Yonghong;LIN Qi;YANG Jian(Department of Radiology,the First Hospital of Longyan of Fujian Medical University,Longyan 364000,China;Department of Radiology,the First Affiliated Hospital of Medical College,Xi'an Jiaotong University,Xi’an 710061,China)

机构地区：[1]福建医科大学附属龙岩市第一医院医学影像科,龙岩364000 [2]西安交通大学第一附属医院影像科,西安710061

出　　处：《磁共振成像》2019年第3期185-189,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家重点研发计划(编号:2016YFC0100300);福建临床重点专科建设项目(编号:闽卫医政函2018-145)~~

摘　　要：目的探讨磁共振成像常规序列和扩散张量成像(diffusion tensor imaging,DTI)的分数各向异性(factionalanisotropy,FA)值和平均扩散系数(averagediffusion coefficient,ADC)值在足月儿缺血缺氧性脑病(hypoxicischemicencephalopathy,HIE)诊断中的价值。材料与方法 2016年12月至2017年12月收住我院的41例HIE足月儿进行颅脑常规MRI和DTI检查,另取10例正常足月儿作为对照组,分析内囊后肢、胼胝体膝部和压部、额枕叶深部白质、半卵圆中心和豆状核的ADC值、FA值特点、与新生儿行为神经评分(neonatal behavioral neurological assessment,NBNA)的相关性及其诊断HIE的准确度。结果常规MRI的内囊后肢、基底节和丘脑病变仅见于中重度HIE(P<0.05)。除胼胝体膝部和压部外,相同ROI双侧ADC值、FA值无差异(P>0.05)。中度HIE额叶深部白质和重度HIE除豆状核外的ADC值及中重度HIE除豆状核外的FA值低于对照组(P<0.01),轻度HIE各ROI的ADC值及FA值与对照组相仿(P>0.05)。轻度和中重度组间额叶深部白质,轻重度组间胼胝体膝部,轻中度和重度组间枕叶深部白质和半卵圆中心的ADC值及各组间除豆状核外的FA值差异有统计学意义(P<0.05)。结论 FA值反映HIE脑白质损伤程度、范围和预后评估优于ADC值和常规MRI,内囊后肢的FA值与NBNA评分相关性最高。Objective:To discuss the value of the quantitative determination of FA value and ADC value in the brain injury assessment on full-term neonates with HIE.Materials and Methods:From December 2016 to December 2017,41 full-term neonates with HIE in our hospital were examined by conventional MRI and DTI.Another 10 normal full-term neonates were taken as control group.ADC/FA values were calculated in bilateral posterior limb of internal capsule(PLIC),genu of corpus callosum(GCC),splenium of corpus callosum(SCC),frontal white matter(FWM),occipital white matter(OWM),central centrum semiovale(CCS)and lentiform nucleus(LN),and were compared between control group and HIE group.The correlation between FA values and NBNA scores were analyzed,and the diagnostic accuracy of HIE was evaluated.Results:On convention MRI,PLIC,basal ganglia and thalamus lesions were only seen in moderate/severe HIE(P<0.05).Except for GCC and SCC,there was no difference in the ADC value and FA value between the left and right sides of the same ROI(P>0.05).The ADC values of FWM in moderate HIE and severe HIE except LN and FA values of moderate/severe HIE except LN were lower than those of control group(P<0.01).The ADC values and FA values of each ROI in mild HIE were similar to those in the control group(P>0.05).There were significant differences in FA values in mild/moderate/severe HIE and ADC values in FWM,GCC,OWM and SCC between mild and moderate and severe groups(P<0.05).Conclusions:The diagnostic veracity of FA value is superior to ADC value and conventional MRI in HIE.A significant positive correlation is found between FA value in PLIC and NBNA scores.

关 键 词：缺氧缺血 脑 婴儿 新生 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R742[医药卫生—诊断学]