磁共振扩散张量成像检查对新生儿缺氧缺血性脑病的诊断价值及磁共振参数分析  

Diagnostic value and magnetic resonance parameters of diffusion tensor imaging in the diagnosis of neonatal hypoxic ischemic encephalopathy

作　　者：陈露方 刘娇静 周文娟[1] 时胜利 Chen Lufang;Liu Jiaojing;Zhou Wenjuan;Shi Shengi(Department of Radiology,Children's Hospital Afiliated for Zhengzhou University,Henan Children's Hospital,Zhengzhou Children's Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属儿童医院河南省儿童医院郑州儿童医院放射科,郑州450000

出　　处：《中国实用医刊》2024年第6期80-83,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨磁共振扩散张量成像(DTI)检查对新生儿缺氧缺血性脑病(HIE)的诊断价值及磁共振参数。方法描述性研究。抽取2020年8月至2023年8月郑州大学附属儿童医院收治的89例疑似HIE新生儿,均行磁共振DTI检查,并以临床综合诊断为金标准,统计磁共振DTI检查对新生儿HIE的检出情况及诊断效能。采用kappa检验验证磁共振DTI诊断与金标准的一致性。比较HIE新生儿与非HIE新生儿豆状核、半卵圆中心、胼胝体压部、胼胝体膝部、内囊前肢、内囊后肢、额叶白质各向异性分数(FA)值的差异。结果89例疑似HIE新生儿中,临床综合诊断确诊62例,磁共振DTI检出HIE新生儿61例,阳性率为98.39%。磁共振DTI诊断新生儿HIE的灵敏度为96.77%(60/62),特异度为96.30%(26/27),准确度为96.63%(86/89),阳性预测值为98.36%(60/61),阴性预测值为92.86%(26/28);经kappa检验显示,磁共振DTI诊断与临床综合诊断的一致性尚可,kappa值=0.921。HIE新生儿豆状核、半卵圆中心、胼胝体压部、胼胝体膝部、内囊前肢、内囊后肢、额叶白质FA值低于非HIE新生儿,差异有统计学意义(P<0.05)。结论磁共振DTI在新生儿HIE诊断中价值高,可提高诊断准确性,且操作简便,便于尽早开展诊疗工作,更好地改善患儿预后。Objective To investigate the diagnostic value and magnetic resonance parameters of diffusion tensor imaging(DTI)in the diagnosis of neonatal hypoxic ischemic encephalopathy(HIE).Methods A total of 89 suspected HIE newborns admitted to Children’s Hospital Affiliated for Zhengzhou University from August 2020 to August 2023 were selected for the descripitive study.And they all underwent magnetic resonance DTI examination.Clinical comprehensive diagnosis was used as the gold standard,and the detection results and diagnostic efficacy of DTI in the diagnosis of neonatal HIE in newborns were statistically analyzed.Kappa test was used to verify the consistency between magnetic resonance DTI diagnosis and the gold standard.The changes in anisotropic fraction(FA)values between HIE newborns and non HIE newborns in the lenticular nucleus,centrum semiovale,splenium and genu of the corpus callosum,anterior and posterior limbs of the inner capsule,and frontal white matter.Results Of the 89 neonates suspected with HIE,62 cases were confirmed with HIE;and magnetic resonance DTI identified 61 cases with HIE,with a positive rate of 98.39%.The sensitivity of magnetic resonance DTI in diagnosing neonatal HIE was 96.77%(60/62),the specificity was 96.30%(26/27),the accuracy was 96.63%(86/89),the positive predictive value was 98.36%(60/61),and negative predictive value was 92.86%(26/28).The kappa test revealed that the magnetic resonance DTI diagnosis had a good consistency with the gold standard,with the kappa value of 0.921.The FA values of lenticular nucleus,centrum semiovale,splenium and genu of the corpus callosum,anterior and posterior limbs of the inner capsule,and frontal white matter in HIE neonates were lower than those in non HIE neonates,and the difference was statistically significant(P<0.05).Conclusions Magnetic resonance DTI has high value in the diagnosis of neonatal HIE,which has a high diagnostic accuracy and easy operation process.Therefore,it is conductive to performing early diagnosis and treatment,and better impr

关 键 词：缺氧缺血性脑病 新生儿 磁共振扩散张量成像 诊断价值 磁共振参数 

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]