多模态磁共振对HIE程度分级及预后评估的临床价值研究  

Clinical Value Research of Multimode Magnetic Resonance Imaging in Grading and Prognostic Evaluation of HIE

作　　者：于宝龙 陈喆星 崔景霖 柳泽坤 靳金岩 李洪义 YU Baolong;CHEN Zhexing;CUI Jinglin;LIU Zekun;JIN Jinyan;LI Hongyi(Imaging Department,Mudanjiang Medical College the Second Affiliated Hospital,Mudanjiang,Heilongjiang 157000;Magnetic Resonance Department,Mudanjiang Medical College Affiliated Red Flag Hospital,Mudanjiang,Heilongjiang 157011;Imaging Department,Mudanjiang Maternal and Child Health Hospital,Mudanjiang,Heilongjiang 157000)

机构地区：[1]牡丹江医学院附属第二医院影像科,黑龙江牡丹江157000 [2]牡丹江医学院附属红旗医院磁共振科,黑龙江牡丹江157011 [3]牡丹江妇幼保健院影像科,黑龙江牡丹江157000

出　　处：《智慧健康》2024年第22期1-4,共4页Smart Healthcare

基　　金：黑龙江省卫生健康委科研课题《多模态磁共振对HIE程度分级及预后评估的临床价值研究》(课题编号:20220909010989)。

摘　　要：目的通过多模态磁共振获得图像信号特征,观察其在缺氧缺血性脑病(hypoxic-ischemic encephalopathy,HIE)患儿程度分级及预后评估中的临床价值。方法回顾性分析2021年1月—2023年1月在本院确诊为HIE的68例患儿的临床资料,并将其作为HIE组;选取同期的28例健康新生儿为对照组。通过所获取的磁共振(MRI)平扫、弥散、灌注及磁敏感加权图像,进行新生儿颅脑损伤MRI评分,并对临床分度与影像学评分的相关性进行分析;通过观察出血灶及灌注改变情况,评估患儿疾病程度分级及相关预后。结果磁敏感加权成像(susceptibility weighted imaging,SWI)对出血灶的检出率明显高于T1WI序列、T2WI序列及磁共振弥散加权成像(diffusion weighted imaging,DWI)序列(P<0.05);rCBF值在正常组与HIE组间存在差异(P<0.05);不同临床分度HIE患儿不同部位MRI影像学评分及其总评分比较,均为重度组>中度组>轻度组且P<0.05;经Spearman秩相关系数法分析,影像学评分与临床分度呈显著正相关性(r=0.716、0.918、0.939、0.890、0.920,P<0.001)。结论通过头部磁共振常规平扫联合多模态技术手段获取HIE患儿影像学特征,以此对HIE严重程度进行分级,对患儿预后进行综合评估。多模态磁共振对HIE在程度判断及预后评估方面均展示出较高的临床价值,进而为临床提供更全面、准确的临床诊治信息。Objective To explore clinical value of image signal features obtained by multimode magnetic resonance imaging in grading and prognosis evaluation of children with HIE.Methods The paper reviewed and analyzed 68 children diagnosed with HIE from January 2021 to January 2023,and collected 28 healthy newborns as control group.MRI scores of neonatal brain injury were evaluated based on MRI plain scan,diffusion,perfusion and magnetic sensitive weighted images.Correlation between clinical grading and imaging scores was compared,degree of bleeding and perfusion changes was observed to evaluate grading and related prognosis of children.Results Detection rate of bleeding lesions by SWI was significantly higher than T1WI,T2WI and DWI sequences,difference in detection results was statistically significant(P<0.05).There was statistically significant difference in rCBF values between normal group and HIE group,with P<0.05.Moreover,comparison of MRI imaging scores and total scores of different parts of HIE patients with different clinical scores showed,those of severe group>moderate group>mild group,and P<0.05.Spearman rank correlation coefficient analysis showed,correlation between imaging scores and clinical scores were significantly positive(r=0.716,0.918,0.939,0.890,0.920,P<0.001).Conclusion Routine head MRI plain scan combined with multimode technology can obtain imaging features,grade severity of HIE,and evaluate prognosis of patients comprehensively,which can show clinical value in diagnosis of grade and prognosis of HIE,provide more comprehensive and accurate clinical diagnosis and treatment information for clinical practice.

关 键 词：多模态磁共振 新生儿缺血缺氧性脑病 程度分级及预后评估 临床价值 

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]