新生儿脑梗死16例磁共振成像及临床特征分析  

MRI Analysis and Clinical Features of 16 cases of Neonatal Cerebral Infarction

作　　者：董世杰 刘明[2] 郑慧[2] 李欣 DONG Shijie;LIU Ming;ZHENG Hui;LI Xin(Department of Radiology,Henan(Zhengzhou)Childreni Hospital(Children's Hospital Affiliated to Zhengzhou University);Department of Radiology,Xinhua Hospital.Shanghai Jiao Tong University School of Medicine)

机构地区：[1]河南省儿童医院郑州儿童医院(郑州大学附属儿童医院)放射科 [2]上海交通大学医学院附属新华医院放射科

出　　处：《中国医学计算机成像杂志》2021年第4期330-335,共6页Chinese Computed Medical Imaging

摘　　要：目的:探讨新生儿脑梗死(NCI)的MRI、磁共振血管成像(MRA)及临床特征,提高对本病的认识及诊断水平。方法:回顾性分析2018年1月—2020年1月郑州大学附属儿童医院新生儿科收治的16例NCI临床及头颅MRI资料,总结其临床特点及头颅MRI、MRA表现。结果:16例患儿中13例(81.25%)病灶位于左侧大脑中动脉供血区;16例初次就诊MRI弥散序列均出现斑片状弥散受限信号[弥散加权成像(DWI)高信号,表观弥散系数(ADC)图低信号]者,病变累及同侧皮质脊髓束(内囊后肢及大脑脚)、基底节、丘脑及胼胝体者分别有13例(81.3%)、6例(37.5%)、5例(31.3%)、3例(18.8%)。10例患儿初诊同时行头颅MRA检查,7例表现为同侧大脑中动脉增粗、分支增多,均未发现栓塞及血供中断现象。16例患儿临床均表现有精神反应差、食乳欠佳、原始反射引不全等不典型表现,其中病变初期合并有抽搐14例(87.5%)。对11例患儿进行了随访,MRI显示病灶最终均演变成软化灶。结论:新生儿脑梗死病灶多见于左侧大脑中动脉供血区,病变初期于磁共振弥散序列出现异常信号并常累及同侧皮质脊髓束、基底节、丘脑、胼胝体是其MRI特点;临床表现缺乏特异性,抽搐一般是其早期常见体征;急性期颅脑MRA未显示梗塞血管不能除外新生儿脑梗死;病灶最终演变成软化灶。Purpose:To investigate the magnetic resonance imaging(MRI),magnetic resonance angiography(MRA)and clinical characteristics of neonatal cerebral infarction,and to improve the understanding and diagnosis of the disease.Methods:The clinical features and MRI data of 16 cases of neonatal cerebral infarction treated in the Department of Neonatology,Henan(Zhengzhou)Children’s Hospital(Children’s Hospital Affiliated to Zhengzhou University)from January 2018 to January 2020 were analyzed by regression analysis.Results:Among 16 children,13(81.3%)lesions were located in the left middle cerebral artery supply area.All 16 children showed patchy diffusion restriction(high intensity signal on DWI and low intensity signal on ADC)on the MRI diffusion sequence.The lesions involved ipsilateral corticospinal tract(posterior limb of internal capsule and cerebral foot),basal ganglia,thalamus and corpus callosum in 13 cases(81.3%),6 cases(37.5%)5 cases(31.3%)and 3 cases(18.8%),respectively.MRA was performed in 10 patients at the same time.Seven patients showed enlargement of ipsilateral middle cerebral artery and increase of branches.No embolism or blood supply interruption was found.The clinical manifestations of the 16 cases were poor mental response,poor milk intake,incomplete original reflex and other atypical manifestations,of which 14 cases(87.5%)were complicated with convulsions at the initial stage of the disease.All the 11 cases were followed up.MRI showed that the lesions eventually developed into liquefaction.Conclusion:Neonatal cerebral infarction is more common in the left middle cerebral artery blood supply area,and its MRI features are abnormal signal on MRI diffusion sequence and the involvement of ipsilateral corticospinal tract,basal ganglia,thalamus and corpus callosum.The clinical manifestations are lack of specificity,and convulsions are generally the early common signs.Neonatal cerebral infarction cannot be excluded when cerebral MRA in acute phase does not display infarcted blood vessels.The lesions eventuall

关 键 词：脑梗死 新生儿 弥散受限 磁共振成像 磁共振血管成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]