新生儿神经行为异常与头颅MRI的相关性  

Correlation between neonatal neurobehavioral abnormalities and cranial MRI

作　　者：王玲莉 王德志 郑茵茹 WANG Lingli;WANG Dezhi;ZHENG Yinru(Department of Pediatrics,Huangshan City People’s Hospital,Anhui Province,Huangshan 245000,China)

机构地区：[1]安徽省黄山市人民医院儿科,安徽黄山245000

出　　处：《妇儿健康导刊》2022年第8期63-66,共4页JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE

摘　　要：目的了解新生儿神经行为异常的头颅MRI的改变,以评估判断新生儿脑损伤严重程度及预后。方法选取2017年1月至2018年12月黄山市人民医院收治的358例伴有不同程度神经行为异常表现的新生儿的临床资料,另抽取50例单纯新生儿头皮血肿临床资料进行分析。结果358例有不同程度神经行为异常表现新生儿中,头颅MRI异常病例192例,占总病例数的53.6%。50例无神经行为异常表现病例中,发现头颅MRI异常有11例,占总数的22.0%。重度神经行为异常表现新生儿,其头颅MRI有着更高异常发生率。头颅MRI异常信号分布与病因密切相关,窒息所致脑损伤头颅MRI异常改变主要表现为脑实质弥漫性高信号影,基底节、丘脑损伤时呈双侧对称性高信号影;低血糖脑损伤异常信号影主要位于顶枕叶,大部分为双侧;高胆红素血症所致脑损伤异常信号影主要位于双侧苍白球。随访358例患儿,有8例失访,1例死亡,6例伴有明显智力落后、脑瘫后遗症,17例有不同程度运动发育落后,余预后良好。结论新生儿神经行为异常与头颅MRI异常有着密切关系,其中有着重度神经行为异常表现新生儿,其头颅MRI损伤部位更多,面积更广,预后相对更差。产时窒息仍是构成新生儿头颅MRI异常改变的最主要病因。Objective To understand the changes of cranial MRI of neonatal neurobehavioral abnormalities,in order to evaluate the severity and prognosis of neonatal brain injury.Methods The clinical data of 358 neonates with different degrees of neurobehavioral abnormalities admitted to Huangshan City People’s Hospital from January 2017 to December 2018 were selected,and the clinical data of 50 cases of simple neonatal scalp hematomas were selected for analysis.Results Among the 358 neonates with different degrees of neurobehavioral abnormalities manifestations,192 cases were abnormal head MRI,accounting for 53.6%of the total cases.Among the 50 cases without abnormal neurobehavioral manifestations,11 cases were found to be abnormal on head MRI,accounting for 22.0%of the total.Neonates with severe neurobehavioral abnormalities had a higher incidence of cranial MRI abnormalities.The abnormal signal distribution of cranial MRI was closely related to the cause.The abnormal changes of cranial MRI caused by asphyxia were mainly manifested as diffuse high signal intensity in the brain parenchyma,basal ganglia and thalamus showed bilateral symmetrical hyperintensity in the case of injury.The abnormal signal in hypoglycemic brain injury was mainly located in the parieto-occipital lobe,most of which were bilateral.The abnormal signal shadow of brain injury caused by hyperbilirubinemia was mainly located in the bilateral globus pallidus.Among 358 cases of follow-up,8 cases were lost to follow-up,1 cas e died,6 cases had obvious mental retardation and cerebral pals y sequelae,17 cases had different degrees of motor development retardation,and the prognosis of the rest was good.Conclusion Neonatal neurobehavioral abnormalities are closely related to cranial MRI abnormalities.Neonates with severe neurobehavioral abnormalities have more cranial MRI injury sites,wider areas,and relatively poorer prognosis.Intrapartum asphyxia is still the main cause of abnormal changes in neonatal cranial MR I.

关 键 词：神经行为异常 头颅影像 MRI 相关性 

分 类 号：R714.21[医药卫生—妇产科学]