DTI扫描与常规MRI检查在评估足月儿缺氧缺血性脑病严重程度的价值  

Application of DTI and Routine Magnetic Resonance Imaging in Evaluating the Severity of Mature Neonates Hypoxic⁃ischemic Encephalopathy

作　　者：马德有[1] 毛玉红 尚红磊 关牧娟[3] MA Deyou;MAO Yuhong;SHANG Honglei(Department of Rehabilitative Medicine,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan Province 450052,P.R.China)

机构地区：[1]郑州大学第三附属医院康复医学科,450052 [2]郑州大学第五附属医院心电图室 [3]郑州大学第三附属医院医学影像科,450052

出　　处：《临床放射学杂志》2023年第9期1497-1501,共5页Journal of Clinical Radiology

基　　金：河南省科技攻关项目(编号:222102310596)。

摘　　要：目的观察对比扩散张量成像(DTI)扫描与常规MRI检查在评估足月儿缺氧缺血性脑病(HIE)严重程度方面的价值。方法选取40例足月HIE患儿(轻度13例,中度15例,重度12例)作为研究对象,观察分析不同严重程度HIE的常规MRI影像学特征及DTI参数特征。结果常规MRI显示HIE严重程度与病变累及部位及范围相关,其区分轻度与中重度HIE的敏感度为76.9%,特异度81.5%,假阳性率18.5%,假阴性率23.1%,准确性80.0%。DTI参数显示内囊后肢FA值在不同严重程度HIE均有统计学差异,当内囊后肢FA值取临界值0.41时,区分轻度与中重度HIE的诊断效能最大(敏感度100%,特异度85.2%,假阳性率14.8%,假阴性率0,准确性90.0%)。两种方法在区分轻度与中重度HIE时一致性较好(Kappa值=0.792,P<0.001),且DTI扫描的诊断效能更佳。结论DTI定量参数较常规MRI检查能更好地评估足月儿HIE严重程度,从而为评估患儿预后及提示临床尽早针对性实施干预奠定基础。Objective Explore the value of diffusion tensor imaging(DTI)and routine magnetic resonance imaging(MRI)in evaluating the severity of mature neonatal hypoxic⁃ischemic encephalopathy(HIE).Methods 40 full⁃term newborns with HIE(mild 13 cases,moderate 15 cases and severe 12 cases)were included.The conventional MRI charac⁃teristics and DTI parameters of all cases were analyzed.Results Routine MRI showed that the severity of HIE was related to the sites and range of lesions involved.The sensitivity,specificity,false positive rate,false negative rate and accuracy of distinguishing mild from moderate⁃severe HIE were 76.9%,81.5%,18.5%,23.1%and 80.0%respectively.DTI pa⁃rameters demonstrated that there were statistical differences in FA values of inner capsule hind limb among different degrees of HIE.When FA value of inner capsule hind limb was set to optimal cutoff point 0.41,the diagnostic efficiency of differ⁃entiating mild from moderate⁃severe HIE was the best(sensitivity 100%,specificity 85.2%,false positive rate 14.8%,false negative rate 0,accuracy 90.0%).The two methods showed good consistency in distinguishing mild from moderate⁃severe HIE(Kappa=0.792,P<0.001),and DTI was of better diagnostic efficiency.Conclusion Compared with rou⁃tine MRI,DTI can be used as a more accurate quantitative index to evaluate the severity of mature neonatal HIE,thus pla⁃ying an important role for clinicians in accurately predicting prognosis and implementing earlier targeted intervention.

关 键 词：扩散张量成像 磁共振成像 缺氧缺血性脑病 足月儿 

分 类 号：R445.2[医药卫生—影像医学与核医学] R722.1[医药卫生—诊断学]