足月缺氧缺血性脑病患儿氢质子磁共振波谱与新生儿行为神经测定评分的相关性  被引量:5

Correlation Between Hydrogen Proton Magnetic Resonance Spectroscopy and Neonatal Behavioral Neurological Assessment Score in Full-Term Neonates with Hypoxic-Ischemic Encephalopathy

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作  者:席艳丽[1] 王瑞珠 高峰[1] 杨明[1] 卞宠平 XI Yanli;WANG Ruizhu;GAO Feng;YANG Ming;BIAN Chongping(Department of Radiology,Children's Hospital of Nanjing Medical University,Nanjing 210008,China)

机构地区:[1]南京医科大学附属儿童医院放射科,江苏南京210008

出  处:《中国医学影像学杂志》2022年第11期1102-1107,1112,共7页Chinese Journal of Medical Imaging

基  金:南京市卫生科技发展项目(YKK14117)。

摘  要:目的探讨足月缺氧缺血性脑病(HIE)患儿不同回波时间(TE)豆状核区氢质子磁共振波谱(~1H-MRS)代谢物比值与新生儿行为神经测定(NBNA)评分的相关性。资料与方法回顾性研究2019年7月—2020年12月南京医科大学附属儿童医院新生儿科54例足月HIE患儿,根据NBNA评分分为无神经行为异常组30例和合并神经行为异常组24例,选取20例正常足月新生儿作为对照组,分别选用TE=135 ms和TE=35 ms行头颅~1H-MRS三维多体素扫描,检测所有研究对象豆状核区代谢物N-乙酰天门冬氨酸(NAA)、胆碱(Cho)、肌酸(Cr)、乳酸(Lac),计算NAA/Cr、Cho/Cr、NAA/Cho、Lac/Cr、Lac/NAA、Lac/Cho比值,比较3组不同TE~1H-MRS代谢物比值的差异,并分析其与NBNA总分及各子项目评分的相关性。结果3组间NBNA总分及行为能力、主动肌张力子项目评分差异有统计学意义(F=19.891、5.394、6.178,P均<0.01);3组间豆状核区TE=135 ms时NAA/Cho和TE=35 ms时Lac/Cr、Lac/Cho、Lac/NAA差异均有统计学意义(F=7.597、4.236、4.218、6.758,P均<0.01);豆状核区TE=135 ms时,NAA/Cho与NBNA总分呈正相关(r=0.468,P=0.008),与行为能力及主动肌张力子项目评分均呈中高度相关(r=0.625、0.794,P<0.001);TE=35 ms时,Lac/NAA与NBNA总分呈负相关(r=-0.454,P=0.011),与行为能力及主动肌张力子项目评分呈中度负相关(r=-0.680、-0.694,P<0.001)。结论不同TE~1H-MRS豆状核区部分代谢物指标能定量反映HIE患儿脑损伤严重程度,其中TE=135 ms时NAA/Cho和TE=35 ms时Lac/NAA均与NBNA评分具有相关性,可为临床诊断HIE提供参考。Purpose To investigate the correlation between hydrogen proton magnetic resonance spectroscopy(~1H-MRS)metabolite ratios of different echo time(TE)in lenticular nucleus region and neonatal behavioral neurological assessment(NBNA)score of full-term newborns with hypoxic ischemic encephalopathy(HIE).Materials and Methods A retrospective study was conducted on 54 full-term neonates with HIE in the Affiliated Children’s Hospital of Nanjing Medical University from July 2019 to December 2020,according to the NBNA score,all subjects were divided into no neurobehavioral abnormality group(n=30)and combined neurobehavioral abnormality group(n=24),and 20normal full-term newborns were used as the control group.TE=135 ms and TE=35 ms were used to perform cerebral three-demensional multivoxel~1H-MRS scanning,the metabolites of N-acetylaspartate(NAA),choline(Cho),creatine(Cr)and lactic acid(Lac)in the lenticular nucleus region of all subjects were further detected.The ratios of NAA/Cr,Cho/Cr,NAA/Cho,Lac/Cr,Lac/NAA and Lac/Cho were calculated,and the difference of~1H-MRS metabolite ratios at different TE among the three groups were compared,the correlation between~1H-MRS metabolite ratios and NBNA total score and its sub-items score was analyzed.Results There were statistically significant differences in total NBNA and its sub-items such as behavioral ability and initiative muscular tension scores among the three groups(F=19.891,5.394,6.178,P<0.01).There were statistically significant differences in NAA/Cho of TE=135 ms and Lac/Cr,Lac/Cho,Lac/NAA of TE=35 ms in the lenticular nucleus region among the three groups(F=7.597,4.236,4.218,6.758,P<0.01).NAA/Cho of TE=135 ms in the lenticular nucleus region was positively correlated with the total score of NBNA(r=0.468,P=0.008),and was moderately correlated with the scores of behavioral ability and initiative muscular tension(r=0.625,0.794,P<0.001).Lac/NAA of TE=35 ms was negatively correlated with the total score of NBNA(r=-0.454,P=0.011),and moderately correlated with the scores of

关 键 词:缺氧缺血  新生儿 磁共振波谱学 行为神经测定 

分 类 号:R445.2[医药卫生—影像医学与核医学] R742[医药卫生—诊断学]

 

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