DKI衍生参数预测新生儿缺氧缺血性脑病预后  

DKI Derived Parameters Predict the Prognosis of Neonatal HIE

作　　者：刘祥龙[1,2] 岳翔 赵鑫[1] 陆林[1] 张博浩[1] 张小安 王雪源[1] LIU Xianglong;YUE Xiang;ZHAO Xin(Department of Medical Imaging,Third Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan Province 45000,P.R.China)

机构地区：[1]郑州大学第三附属医院医学影像科 [2]河南科技大学临床医学院,450000

出　　处：《临床放射学杂志》2024年第10期1787-1793,共7页Journal of Clinical Radiology

基　　金：国家自然基金资助项目(编号:82371919);河南省科技攻关资助项目(编号:242102310011);郑州大学第三附属医院博士科研启动金专项经费(编号:BS20230112)。

摘　　要：目的探究扩散峰度成像(DKI)在新生儿缺氧缺血性脑病(HIE)预后评估中的价值。方法以行MRI检查且被临床诊断为HIE的新生儿66例为研究对象,进行颅脑常规MRI和DKI的扫描,并测量感兴趣区(ROI)的DKI衍生参数,将其与14天时新生儿行为神经行为测定(NBNA)评分及6个月、12个月时Gesell婴幼儿发展量表(Gesell)评分进行Spearman秩相关分析。Mann-Whitney U秩和检验用来比较预后好组与预后差组间的DKI衍生参数差异,并利用受试者工作特征曲线(ROC curve)来分析DKI衍生参数的预测预后效能。结果部分DKI衍生参数与NBNA、6个月Gesell评分及12个月Gesell评分具有一定相关性。尾状核、胼胝体压部的平均扩散浓度(MK)值,尾状核的轴向扩散峰度(Ka)值,苍白球、壳核的径向扩散峰度(Kr)值及半卵圆中心层面中央白质的各向异性分数(FA)值在预后好组与预后差组间表现出明显的差异,且预后好组的值大于预后差组,其中所有参数的联合诊断效能最高(曲线下面积为0.815),胼胝体压部的Kr值可鉴别预后好组和预后差组间的差异(曲线下面积为0.738),胼胝体压部的MK值和Kr值可鉴别预后好组和预后差组间的差异(曲线下面积分别为0.810和0.838)。结论DKI衍生参数可以作为临床对新生儿HIE的预后评估的潜在指标,可为制定更优治疗方案提供相关依据。Objective To explore the value of diffusion kurtosis imaging(DKI)in the prognostic evaluation of neonatal hypoxic ischemic encephalopathy(HIE).Methods A total of 66 newborns diagnosed with HIE through MRI examination in our hospital were selected as the study subjects.Routine cranial MRI and DKI scans were performed,and the DKI derived parameters of the region of interest(ROI)were measured.Spearman rank correlation analysis was performed between these parameters and neonatal behavioral neurological assessment(NBNA)scores at 14 days and Gesell scores at 6 and 12 months.The Mann Whitney U rank sum test is used to compare the differences in DKI derived parameters between the group with good prognosis and the group with poor prognosis,and to analyze the prognostic efficacy of DKI derived parameters using receiver operating characteristic curve(ROC curve).Results Some DKI derived parameters had a certain correlation with NBNA,6-month Gesell score,and 12-month Gesell score.The MK values of the caudate nucleus,the pressure part of the corpus callosum,the Ka values of the caudate nucleus,the Kr values of the globus pallidus and putamen,and the FA values of the central white matter at the central level of the semiovale showed significant differences between the good prognosis group and the poor prognosis group.The values of the good prognosis group were higher than those of the poor prognosis group,and the combined diagnostic efficacy of all parameters was the highest(area under the curve was 0.815),The Kr value of the corpus callosum pressure can distinguish the difference between the good prognosis group and the poor prognosis group(area under the curve is 0.738),while the MK value and Kr value of the corpus callosum pressure can distinguish the difference between the good prognosis group and the poor prognosis group(area under the curve is 0.810 and 0.838,respectively).Conclusion DKI derived parameters can serve as potential prognostic indicators for neonatal HIE in clinical practice,providing relevant basis for develo

关 键 词：新生儿缺氧缺血性脑病 扩散峰度成像 白质 NBNA评分 Gesell评分 

分 类 号：R722.1[医药卫生—儿科]