摘要
目的 探讨MRI不同序列扫描 在新生儿缺氧缺血性脑损伤(HIE)诊断 的应用情况。方法 回顾性分析32例 临床确诊为HIE患儿的MRI图像,采用 常规磁共振图像(MRI)、弥散加权成像 (DWI)及其表观弥散系数值(ADC)、磁敏 感加权成像(SWI)扫描,评估不同扫描 序列在HIE诊断中的应用。结果 常规 MRI+SWI+DWI诊断HIE的阳性率为90.63% 显著高于常规MRI+SWI(65.63%)、常规 MRI+DWI(59.38%)、常规MRI(43.75%)(P <0.05)。常规MRI共检出12例为HIE,其 中5例T1高信号;8例T2高信号,灰白质 无清晰界限;常规MRI+DWI检出19例为 HIE,其中10例基底节区、丘脑等部位在 DWI图上为高信号,呈片状分布,ADC图像 上表现为信号减低。常规MRI+DWI+SWI共 检出21例HIE,其中16例在SWI图像呈扇 形、斑点状及斑片状分布的低信号。结论 MRI+SWI+DWI序列联合扫描可提高HIE诊断 准确率。
Objective To investigate the application of different sequence scan of MRI in the diagnosis of neonatal hypoxic ischemic encephalopathy (HIE). Methods The MRI images of 32 children with clinically diagnosed HIE were retrospectively analyzed. Conventional magnetic resonance imaging (MRI), diffusion weighted imaging (DWI) and its apparent diffusion coefficient (ADC) and magnetic susceptibility weighted imaging (SWI) can were used to evaluate the application of different scanning sequences in the diagnosis of HIE. Results The positive rate of conventional MRI+SWI+DWI in the diagnosis of HIE (90.63%) was significantly higher than that of conventional MRI+SWI (65.63%), conventional MRI+DWI (59.38%) and conventional MRI (43.75%) (P<0.05). 12 cases of HIE were detected by conventional MRI, including 5 cases showing T1 high signal. 8 cases showing T2 high signal and cinereum matter was without clear boundaries. 19 cases with HIE were detected by MRI+DWI, including 10 cases of basal ganglia, thalamus and other areas showing high signal on DWI images, patchy in distribution and signal decline on ADC images. 21 cases of HIE were detected by conventional MRI+DWI+SWI, including 16 cases showing low signal, the SWI images showed a fanshaped, spot-like and patchy in distribution on SWI images. Conclusion The combined MRI+SWI+DWI sequence can improve the diagnostic accuracy of HIE.
【关键词】新生儿缺氧缺血性脑损伤;磁共振成像;弥散加权成像;磁敏感加权成像;扫描序列;影 像学表现
【中图分类号】R722.12
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2016.06.002
前言
新生儿缺氧缺血性脑病(hypoxic-ischemic encephaloparhy, HIE)是围产期较为常见的疾病,与宫内窘迫、新生儿窒息密切相关, 是新生儿死亡的重要原因之一。据统计,国内HIE发病率占活产儿的 5%~10%[1]。有文献指出,早期诊断HIE,早期干预治疗,有利于提高 患儿预后生活质量[2]。以往临床常根据产科疾病史、CT、B超等影像学 诊断HIE,但诊断的早期HIE敏感性较低。近年来,MRI逐渐用于临床 HIE诊断中,但单纯MRI受新生儿脑部髓鞘发育不成熟、含水量大的影 响,存在局限性。现阶段,弥散加权成像(DWI)及其表观弥散系数值 (ADC)、磁敏感加权成像(SWI)等技术用于HIE诊断的报道较多,为临床 诊断早期HIE提供了新途径。基于此,本文探讨了HIE不同MRI序列的影 像学表现,现报道如下。
中国CT和MRI杂志
第14卷, 第 6 期
2016年06月
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