MRI在新生儿缺氧缺血性脑病临床诊断及预后评估中的应用观察  

Application of MRI in the Clinical Diagnosis and Prognosis Evaluation of Neonatal Hypoxic-ischemic Encephalopathy

作　　者：聂春霞 NIE Chun-xia(Department of Neonatology,Luoyang Maternal and Children Health Hospital,Luoyang 471000,Henan Province,China)

机构地区：[1]洛阳市妇幼保健院新生儿科,河南洛阳471000

出　　处：《中国CT和MRI杂志》2021年第4期8-9,42,共3页Chinese Journal of CT and MRI

摘　　要：目的探究磁共振成像(MRI)在新生儿缺氧缺血性脑病(HIE)临床诊断及预后评估中的应用价值。方法回顾性分析2017年1月至2019年6月我院68例HIE患儿临床资料,患儿在治疗前后均行MRI检查。比较不同临床分度HIE患儿MRI影像学评分差异,并使用Spearman秩相关系数法评估HIE患儿MRI影像学评分与临床分度的相关性;记录患儿治疗6个月后神经系统异常情况,分为神经系统异常组(预后较差组)及无神经系统异常组(预后较好组),比较其MRI影像学评分差异。结果68例HIE患儿临床分度Ⅰ度11例,Ⅱ度25例,Ⅲ度32例;不同临床分度HIE患儿各部位MRI影像学评分及其总评分比较,均为Ⅰ度组<Ⅱ度组<Ⅲ度组(P<0.05)。经Spearman秩相关系数法分析,发现HIE患儿各部位MRI影像学评分及其总评分均与临床分度呈显著正相关性(r=0.344、0.385、0.405、0.336、0.483,P<0.05)。治疗6个月后,68例HIE患儿出现神经系统异常11例,纳入预后较差组;无神经系统异常57例,纳入预后较好组;预后较差组各部位MRI影像学评分及其总评分均高于预后较好组(P<0.05)。结论MRI在HIE诊疗中发挥重要作用,MRI影像学评分能判断患儿病情发展及预后情况,指导临床治疗。Objective To explore the application value of magnetic resonance imaging(MRI)in the clinical diagnosis and prognosis evaluation of neonatal hypoxic-ischemic encephalopathy(HIE).Methods The clinical data of 68 childrens patients with HIE in our hospital from January 2017 to June 2019 were retrospectively analyzed.All childrens patients underwent MRI before and after treatment.The differences in MRI imaging sco res we re compa red among children with diffe rent clinical grades of HIE,and the Spearman rank correlation coefficient method was used to evaluate the correlation between MRI imaging score and the clinical grades of HIE children.The neurological abnormalities were after 6 months of treatment,and the children patients were divided into neurological abnormality group(poor prognosis group)and non-neurological abnormality group(good prognosis group),and the differences in MRI imaging score were compared.Results Among 68 children with HIE,there were 11 cases of clinicalgradeⅠ,25 cases of clinical-gradeⅡ,and 32 cases of gradeⅢ.MRI imaging scores of different pa rts and total score of HIE children patients with different clinical grades showed that gradeⅠgroup<gradeⅡgroup<gradeⅢgroup(P<0.05).Spearman rank correlation coefficient method showed that MRI imaging scores of different parts and total score of HIE children patients were significantly positively correlated with clinical grading(r=0.344,0.385,0.405,0.336,0.483,P<0.05).After 6 months of treatment,among 68 children with HIE,there were 11 cases with neurological abnormalities and were included in poor prognosis group,and there were 57 cases without neurological abnormalities and were included in a good prognosis group.The MRI imaging sco res of different parts and total sco re in poor prognosis group were higher than those in good prognosis group(P<0.05).Conclusion MRI plays an essential role in the diagnosis and treatment of HIE.MRI imaging score can judge the disease development and prognosis and guide clinical treatment.

关 键 词：新生儿缺氧缺血性脑病 MRI 临床分度 预后 

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]