颅脑超声、MRI结合血清HIF-1a在新生儿脑损伤诊断、预后评估中的应用  

Application of Craniocerebral Ultrasound,MRI Combined with Serum HIF-1a in the Diagnosis and Prognosis Evaluation of Neonatal Brain Injury

作　　者：王晶萍 闫琼 吴晓明[1] 宋晶 张晓燕 陈亚南 周燕 WANG Jing-ping;YAN Qiong;WU Xiao-ming;SONG Jing;ZHANG Xiao-yan;CHEN Ya-nan;ZHOU Yan(Department of ultrasound,suzhou high-tech zone people's hospital Suzhou city,Suzhou 215129,Jiangsu Province,China)

机构地区：[1]苏州高新区人民医院超声科,江苏苏州215129

出　　处：《中国CT和MRI杂志》2022年第10期7-9,共3页Chinese Journal of CT and MRI

基　　金：苏州高新区医疗卫生科技计划项目(2020Q002);苏州高新区人民医院科学创新基金项目(SGY2021B01)。

摘　　要：目的研究颅脑超声、磁共振成像(MRI)结合血清低氧诱导因子-1a(HIF-1a)在新生儿脑损伤诊断、预后评估中的应用效果。方法选取2016.5至2019.11我院儿科录入符合入选标准的的62例新生儿为研究对象,均进行颅脑超声及MRI检查,比较诊断结果,比较新生儿检查时及脑损伤后6个月HIF-1a水平来评估预后。结果62例新生儿中有57例患儿有影像学异常征象,MRI阳性检出率为80.70%(46/57),颅脑超声阳性检出率为56.14%(32/57),MRI阳性检出率明显较高,差异具有统计学意义(P<0.05)。MRI对脑水肿、硬膜下或蛛网膜下腔出血的检出率明显高于超声(P<0.05),而超声对脑室周围、脑室内出血的检出率明显高于MRI(P<0.05)。两者对脑室周围出血性梗死、脑积水、多部位损伤的检出率无明显差异(P>0.05)。脑损伤后6个月,HIF-1a水平明显低于检查时,差异有统计学意义(P<0.05)。结论MRI结合HIF-1a在新生儿脑损伤诊断、预后评估方面的应用效果优于头颅超声,但在脑室周围、脑室内出血方面的检出率不如头颅超声,临床可根据患儿情况选择合适检查方案。Objective To study the application effects of craniocerebralultrasound,magnetic resonance imaging(MRI)combined with serum hypoxia-inducible factor-1a(HIF-1a)in the diagnosis and prognosis evaluation of neonatal brain injury.Methods Sixty-two neonates who met inclusion criteria and entered the pediatrics department of our hospital from May 2016 to November 2019 were selected as the research subjects.All of them were subjected to craniocerebral ultrasound and MRI.The diagnosis results were compared.The prognosis was assessed by comparing HIF-1a level at neonatal examination and at 6 months after brain injury.Results Among the 62 neonates,57 cases had abnormal imaging signs.The positive detection rate of MRIwas 80.70%(46/57),and thepositive detection rate of craniocerebral ultrasound was 56.14%(32/57),and the positive detection rate of MRI was significantly higher(P<0.05).The detection rates of cerebral edema and subdural or subarachnoid hemorrhageof MRI were significantly higher than those of ultrasound(P<0.05),and the detection rates ofperiventricularhemorrhag and intraventricular hemorrhage of ultrasound were significantly higher than those of MRI(P<0.05).There were no significant differences in the detection rates of periventricularhemorrhagic infarction,hydrocephalus and multi-site injury between the two examination methods(P>0.05).At 6 months after brain injury,the HIF-1a level was significantly lower than that at examination(P<0.05).Conclusion MRI combined with HIF-1a has better application effects thancraniocerebral ultrasound in the diagnosis and prognosis evaluation of neonatal brain injury,but its detection rates of periventricularhemorrhag and intraventricular hemorrhage are not as good as those of craniocerebral ultrasound.The appropriate examination regimen can be selected according to the situation of children patients in clinical practice.

关 键 词：颅脑超声 磁共振成像 低氧诱导因子-1A 新生儿 脑损伤 

分 类 号：R445.2[医药卫生—影像医学与核医学]