小儿低血糖脑损伤的CT、MR诊断  

Imaging Diagnosis of Hypoglycemic Brain Injury in Children

作　　者：张宝明 孙多成[1] 汪建华[1] 杜苑瑜 ZHANG Bao-ming;SUN Duo-cheng;WANG Jian-hua;DU Yuan-yu(Department of Medical Imaging ZhongshanBo'aihospital,Zhongshan 528400,Guangdong Province,China)

机构地区：[1]广东省中山市博爱医院医学影像科,广东中山528400

出　　处：《中国CT和MRI杂志》2023年第4期19-21,共3页Chinese Journal of CT and MRI

基　　金：多模态MRI监测早产儿低血糖脑损伤基金资助项目名称(中山科发(2019)156号)。

摘　　要：目的 研究新生儿及早产儿低血糖脑损伤的CT、 MRI特点。方法 总结分析,收集本院2010年1月至2020年12月临床诊断为19例小儿低血糖脑病的CT、MRI影像材料。结果 回顾总结小儿低血糖脑病的CT、 MRI特征。CT常双枕顶叶的灰白质对称性条状低密度边缘模糊影,合并双侧胼胝体压部对称性片状低密度,边缘模糊。晚期顶枕叶脑沟增宽萎缩。CT发现5例涉及部分颅内部位无描述,对上述病例进行阅片改良模式后,发现有低血糖脑损伤早期影像,须掌握影像读片的方法,充分发挥薄层后处理重建功能,调动适当的窗位窗宽,细致查找,对早期轻微低血糖脑病改变及时诊断。MRI表现常有位置选择,大部分呈对称改变;新生儿及早产儿低血糖脑损伤大多数在双侧顶枕叶皮层及皮层下白质范围为主、部分涉及到胼胝体压部,部分表现弥漫皮层及皮层下白质受累,甚至基底节受侵,脑干、幕下小脑未见病灶。所有患者需加扫DWI序列后,大大提高了对该病的诊断。结论 应该在认识CT、MRI各种低血糖脑损伤征像的同时,还要注意读片方法和技巧,才能减少低血糖脑病的后遗症。Objective To study the Computed tomography and Magnetic resonance imaging features of hypoglycemic brain injury in newborns and preterm infants.Methods The Computed tomography and Magnetic resonance imaging imaging materials of nineteen children with hypoglycemic encephalopathy diagnosed in our hospital from January 2012 to December 2020 were summarized and analyzed.Results The Computed tomography and Magnetic resonance imaging features of hypoglycemic encephalopathy in children were reviewed.On Computed tomography,the gray and white matter of both occipital and parietal lobes were symmetrical strip-shaped low-density edge blurred shadow,combined with symmetrical sheet-like low-density and fuzzy edge of the pressing part of bilateral corpus callosum.In the late stage,the parietal occipital sulcus widened and atrophied.Computed tomography found that five cases involved some intracranial parts without description.After the improved film reading mode of the above cases,it was found that there were early images of hypoglycemic brain injury.It is necessary to master the method of image reading,give full play to the function of thin-layer postprocessing and reconstruction,mobilize appropriate window width,search carefully,and diagnose the changes of early mild hypoglycemic encephalopathy in time.Magnetic resonance imaging often showed location selection,and most of them showed symmetrical changes;Most hypoglycemic brain injuries in newborns and preterm infants are mainly in bilateral parietooccipital cortex and subcortical white matter,some involve the pressure part of corpus callosum,some show diffuse cortical and subcortical white matter involvement,even basal ganglia invasion,and no lesions are found in brain stem and subcortical cerebellum.All patients need to scan DWI sequence,which greatly improves the diagnosis of the disease.Conclusion We should not only understand various signs of hypoglycemic brain injury on Computed tomography and Magnetic resonance imaging,but also pay attention to film reading methods and

关 键 词：小儿 低血糖脑病 计算机电子成像 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]