探讨头颅MRI-DWI联合血清NSE检测在诊断早产儿局灶性脑白质损伤中的应用价值  

Investigation of application value of cranial MRI-DWI combined with NSE detection in the diagnosis of punctate white matter lesions of premature infants

作　　者：张林 赵朋娜 张倩 张高峰 杨晓云 ZHANG Lin;ZHAO Peng-na;ZHANG Qian(Department of Radiology,Affiliated Children's Hospital of Kunming Medical University(Kunming Children's Hospital),Kunming 650028,China;不详)

机构地区：[1]昆明医科大学附属儿童医院(昆明市儿童医院)放射科,云南昆明650028 [2]玉溪市儿童医院新生儿科,云南玉溪653100

出　　处：《中国医学装备》2021年第7期58-61,共4页China Medical Equipment

基　　金：云南省科技厅科技计划[2018FE001(-099)]“早产儿脑损伤的MRI评价研究”。

摘　　要：目的:探讨头颅磁共振弥散加权成像(MRI-DWI)检查联合血清神经元特异性烯醇化酶(NSE)检测在诊断早产儿局灶性脑白质损伤中的应用价值。方法:选取医院收治的162早产儿,依据脑白质损伤情况将其分为观察组和对照组,每组81例。观察组为局灶性脑白质损伤早产儿,对照组为无脑损伤早产儿。两组早产儿均进行MRI-DWI检查与血清NSE检测,分析头颅MRI-DWI检查联合血清NSE检测对早产儿局灶性脑白质损伤的诊断效能。结果:观察组早产儿MRI-DWI检查中,有12例早产儿MRI信号正常,DWI侧脑室旁白信号增加;51例早产儿MRI的T_(1)加权成像(T_(1)WI)信号加强,偶尔有T_(2)低信号,DWI侧脑室旁白信号增加;18例早产儿MRI的T_(1)WI信号加强,偶尔有T_(2)低信号,DWI信号正常;其中点状损伤65例、簇状损伤13例、中线状损伤3例。观察组早产儿出生第1 d、7 d和14 d的血清NES水平均显著高于对照组,差异有统计学意义(t=22.332,t=22.640,t=24.499;P<0.05)。血清NSE检测和头颅MRI-DWI检查的灵敏度、特异度、准确率和受试者工作特征(ROC)曲线下面积(AUC)均低于头颅MRI-DWI检查联合血清NSE检测,差异有统计学意义(x^(2)_(NSE检测)=67.701,x^(2)=20.930,x^(2)=49.740,x^(2)=30.167;x^(2)_(MRI-DWI检查)=30.649,x^(2)=23.107,x^(2)=28.013,x^(2)=22.197;P<0.05)。结论:头颅MRIDWI检查联合血清NSE检测诊断早产儿局灶性脑白质损伤效能优异,可作为诊断早产儿局灶性脑白质损伤的有效手段。Objective:To investigate the application value of cranial magnetic resonance imaging-diffusion weighted imaging(MRI-DWI)examination combined with serum neuron specific enolase(NSE)detection in the diagnosis of punctate white matter lesions of premature infants.Method:162 premature infants who admitted to hospital were selected,and they were divided into observation group and control group according to the condition of cranial white matter damage,with 81 cases in each group.And 81 premature infants with punctate white matter lesion were divided into observation group,and 81 premature infants without cerebral injury were divided into control group.Both two groups underwent MRI-DWI examination and NSE detection so as to analyze the diagnostic efficiency of the combined examination of MRI-DWI and NSE on cerebral punctate white matter lesions of premature infants.Results:In the MRIDWI examination of observation group,the MRI signals of 12 cases were normal,and the DWI signals of the aside of lateral ventricles of them were increased.The signals of T_(1) weighted imaging(T_(1)WI)of MRI of 51 premature infants were strengthened,occasionally T_(2) was low signal.And the DWI signals of the aside of lateral ventricles of them were increased.The T_(1)WI signals of MRI of 18 premature infants were strengthened,occasionally the signals of T_(2) were low and the DWI signals were normal.Among of them,65 cases were punctum form injury,and 13 cases were cluster form injury and 3 cases were median line injury.The NES levels at the 1th day,the 7th day and 14th day post birth of observation group were significantly higher than those of control group(t=22.332,t=22.640,t=24.499,P<0.05).The sensitivity,specificity,accuracy and area under curve(AUC)of receiver operating characteristics(ROC)curve of NSE examination and cerebral MRI-DWI detection were significantly lower than those of cerebral MRI-DWI combined with NSE(x^(2)_(NSE examination)=67.701,x^(2)=20.930,x^(2)=49.740,x^(2)=30.167,x^(2)_(MRI-DWI detection)=30.649,x^(2)=23.107,x^(2)

关 键 词：血清神经元特异性烯醇化酶(NSE) 磁共振成像(MRI) 头颅 弥散加权成像(DWI) 早产儿 局灶性脑白质损伤 

分 类 号：R445.2[医药卫生—影像医学与核医学]