新生儿缺氧缺血性脑损伤磁共振表现及其病理生理分析  

MRI manifestations and pathophysiological analysis of neonatal hypoxic-ischemic cerebral injury

作　　者：董世杰 李欣[1] 李春鸽 陈志平 DONG Shijie;LI Xin;LI Chunge;CHEN Zhiping(Department of Radiology,Children's Hospital of Zhengzhou University,Zhengzhou 450053,China)

机构地区：[1]郑州大学附属儿童医院放射科,河南郑州450053

出　　处：《医学影像学杂志》2023年第11期1959-1963,共5页Journal of Medical Imaging

摘　　要：目的探讨新生儿缺氧缺血性脑损伤的磁共振表现及其病理生理基础,以提高对此病的诊断水平。方法选取61例确诊新生儿缺氧缺血性脑损伤患儿颅脑MRI资料,根据分娩情况分为早产儿组27例,足月儿组34例,对其MRI常规序列及弥散序列表现回顾性分析。结果早产儿组:单纯室管膜下出血9例,室管膜下出血伴脑室内出血3例,侧脑室体后部旁多发软化灶11例(其中伴室管膜下出血6例),脑室旁实质静脉性梗死4例。足月儿组:单纯室管膜下出血9例,室管膜下出血伴脑室内出血2例,双侧大脑半球局部皮层及皮层下对称性迂曲线状短T_(1)信号5例,双侧脑室旁脑实质内对称性多发点片状短T_(1)信号5例,双侧大脑半球白质弥漫性水肿2例,双侧基底节及丘脑对称性斑片状短T_(1)信号9例,其中4例伴双侧大脑半球弥漫性脑水肿,2例双侧大脑半球皮层下多发囊状软化灶。结论早产及足月新生儿缺氧缺血性脑损伤MRI表现复杂多样,其各种MRI表现可相互重叠,根据早产儿及足月儿生理特点、不同胎龄缺氧缺血性脑损伤病理基础及临床病史可对其进行诊断。Objective To investigate the MRI manifestations and pathophysiological basis of neonatal hypoxic-ischemic cerebral injury,so as to improve the diagnostic level of this disease.Methods 61 cases of clinically diagnosed neonatal hypoxic-ischemic cerebral injury in our hospital were selected for brain magnetic resonance(MRI)data,including 27 premature infants and 34 term infants.Their MRI routine sequence and diffusion sequence manifestations were retrospectively analyzed.Results In premature infants group,there were 9 cases of simple subependymal hemorrhage,3 cases of subependymal hemorrhage accompanied by intraventricular hemorrhage,11 cases of multiple softening foci beside the posterior part of lateral ventricle,including 6 cases of subependymal hemorrhage,and 4 cases of paraventricular parenchymal venous infarction.In term infants group,there were 9 cases of simple subependymal hemorrhage,2 cases of subependymal hemorrhage accompanied by intraventricular hemorrhage,5 cases of bilateral cerebral hemisphere local cortex and subcortical symmetric tortuous short T_(1)signals,5 cases of bilateral paraventricular cerebral parenchyma symmetric multiple punctate short T_(1)signals,and 2 cases of bilateral cerebral hemisphere white matter diffuse edema.There were 9 cases of bilateral basal ganglia and thalamus symmetric patchy short T_(1)signals,of which 4 cases were accompanied by diffuse cerebral edema in bilateral cerebral hemispheres and 2 cases had multiple cystic softening foci under the cortex of bilateral cerebral hemispheres.Conclusion The MRI manifestations of hypoxic-ischemic cerebral injury in premature infants and full-term newborns are complex and diverse,and their various MRI manifestations can overlap with each other.They can be diagnosed according to physiological characteristics of premature infants and full-term infants,pathological basis and clinical history of hypoxic-ischemic cerebral injury at different gestational ages.

关 键 词：早产儿 足月儿 缺氧缺血 脑损伤 磁共振成像 

分 类 号：R722[医药卫生—儿科] R445.2[医药卫生—临床医学]