多模态MRI对新生儿HIE分布模式与临床相关性的诊断价值  

The diagnostic value of multimodal MRI in neonatal HIE distribution pattern and clinical correlation

作　　者：田荣华[1] 邹语嫣 王艳[1] 邓兰婷 杨聪 缴春悦 刘绪纶 马芬[1] TIAN Rong-hua;ZHOU Yu-yan;WANG Yan(Department of Medical Imaging,Xiaogan Central Hospital of Wuhan University of Science and Technology,Hubei 432000,China)

机构地区：[1]武汉科技大学附属孝感医院,湖北432000 [2]锦州医科大学孝感中心医院研究生培训基地,432000

出　　处：《放射学实践》2022年第10期1294-1301,共8页Radiologic Practice

摘　　要：目的:探讨多模态磁共振成像对新生儿缺氧缺血性脑病(HIE)的分布模式与临床相关性的诊断价值。方法:回顾性搜集107例新生儿HIE影像与临床资料,对不同临床分度HIE患儿磁共振图像进行评分,分析其颅脑损伤模式和严重程度。结果:重度HIE患儿基底节/丘脑、内囊后肢、脑干等损伤类型较多,与轻度比较差异均有统计学意义(P<0.05),其中内囊后肢损伤与中度比较差异有统计学意义(P<0.05)。重度HIE患儿MRI总评分比中度和轻度高,差异有统计学意义(P<0.05)。新生儿HIE神经损伤具有选择性和等级性,可以几种损伤类型并存。不同临床分度HIE患儿的分水岭区损伤评分无统计学差异,证明其易损性。重度HIE患儿多发生双侧大脑皮层/皮层下大片损伤,并且多合并基底节/丘脑、罗兰氏区损伤,部分伴有脑干损伤。急性完全性损伤患儿易发生基底节/丘脑损伤或全脑损伤。不完全性损伤可导致分水岭区等易损区损伤。结论:MRI能够客观准确地检测新生儿HIE脑损伤模式和程度,对于新生儿HIE早诊断早干预,预测患儿神经发育结果具有重要意义。Objective:To explore the diagnostic value of multimodal magnetic resonance imaging in the distribution pattern and clinical correlation of neonatal hypoxic-ischemic encephalopathy.Methods:Retrospectively collect the data of 107 children with HIE in our hospital,score the magnetic resonance images of children with HIE in different clinical grades,and analyze the pattern and severity of brain injury.Results:Children with severe HIE are more prone to basal ganglia/thalamus,hindlimb of internal capsule,and brainstem injury,and the difference is statistically significant compared with mild(P<0.05).There is a statistically significant difference between the severe and moderate injuries of the hind limb of the internal capsule(P<0.05).The total MRI score of children with severe HIE was higher than that of moderate and mild children,and the difference was statistically significant(P<0.05).Neonatal HIE nerve damage is selective and hierarchical,and several types of damage can coexist.There is no statistical difference in the watershed scores of children with HIE of different severity,which proves their vulnerability.Children with severe HIE often have large-scale bilateral cerebral cortex and subcortical damage,and most of them are combined with basal ganglia/thalamus and Roland's area damage,and some with brainstem damage.Children with acute complete injury are prone to basal ganglia/thalamus injury or total brain injury.Incomplete damage can cause damage to vulnerable areas such as watershed areas.Conclusions:MRI can objectively and accurately detect the pattern and extent of neonatal HIE brain injury,which is of great significance for early diagnosis and early intervention of neonatal HIE and predicting the neurodevelopmental outcome of children.

关 键 词：婴儿 新生 缺氧缺血 脑 磁共振成像 评分系统 

分 类 号：R195.1[医药卫生—卫生统计学] R743[医药卫生—卫生事业管理] R445.2[医药卫生—公共卫生与预防医学]