新生儿缺血缺氧性脑病应用双源CT与MRI检查及临床分析  

The Application of Dual-source CT and MRI Examination on Neonatal Hypoxic Ischemic Encephalopathy and Clinical Analysis

作　　者：盛杰鑫 王萌[1] 黄光建[1] 王波[1] 薛斌[1] 郑超 SHENG Jie-xin;WANG Meng;HUANG Guang-jian(Department of Radiology,Hanzhong Central Hospital,Hanzhong 723000,Shaanxi Province,China)

机构地区：[1]陕西省汉中市中心医院医学影像诊断科,陕西汉中723000

出　　处：《中国CT和MRI杂志》2020年第7期16-18,共3页Chinese Journal of CT and MRI

摘　　要：目的分析应用双源CT与MRI检查评估新生儿缺血缺氧性脑病(HIE)病情严重程度的效果。方法 2016年4月至2018年7月期间我院新生儿科确诊的240例HIE患儿,轻度98例、中度75例,重度67例,住院期间均完善头部CT与MRI检查,确定CT、MRI分度标准,分析与HIE临床分度相关性,明确CT与MRI评估HIE严重程度与临床分度一致性。结果以HIE临床分度为标准,CT、MRI检查评估HIE严重程度符合率分别为91.25%、93.33%(均>90%),且二者符合率较为接近,无统计学意义(P>0.05)。CT、MRI分度评估HIE严重程度与临床分度诊断一致性极佳,Kappa值为0.772、0.790;且Spearman相关性分析显示,CT、MRI分度与HIE临床分度之间均呈正相关(P<0.05)。当蛛网膜下腔出血时,MRI检出率明显高于CT(P<0.05);当基底节区出血时,CT检出率明显高于MRI(P<0.05)。结论双源CT与MRI检查对于评估HIE病情严重程度有重要价值,二者对于颅内出血的显示各有优缺点。Objective To analyze the effect of dual-source CT and MRI on the severity of neonatal hypoxic ischemic encephalopathy(HIE). Methods 240 children with HIE diagnosed in Division of Neonatology of our hospital from April 2016 to July 2018, there were 98 cases of mild, 75 cases of moderate, and 67 cases of severe by the clinical degree. During the hospitalization, the head CT and MRI examinations were completed, the CT and MRI indexing criteria were determined, the correlation with the HIE clinical index was analyzed, and the consistency of the HIE severity by CT and MRI and clinical index was determined. Results According to the clinical classification of HIE, the coincidence rates of CT and MRI were 91.25% and 93.33%(both>90%), and the coincidence rates were similar between them(P>0.05). The consistency between CT with MRI used to evaluate the consistency of HIE severity and clinical grade diagnosis was excellent, the Kappa values were 0.772 and 0.790, respectively, The Spearman correlation analysis showed that there was a positive correlation between CT, MRI index and HIE clinical index(P<0.05). When subarachnoid hemorrhage, MRI detection rate was significantly higher than CT(P<0.05);when basal ganglia hemorrhage, CT detection rate was significantly higher than MRI(P<0.05). Conclusion Dual-source CT and MRI are important for assessing the severity of HIE. Both have advantages and disadvantages for the display of intracranial hemorrhage.

关 键 词：新生儿缺血缺氧性脑病 X线计算机 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743.3[医药卫生—诊断学]