目的 探讨常规磁共振(MRI)检查 新生儿脑白质损伤(WMD)不同分型与患儿 预后的关系。方法 选取2015年1月-2015 年6月在本院收治的具有窒息病史的早产 儿59例，患儿于出生后2周内在本院接受 MRI检查，其中局灶性WMD 44例、弥漫性 WMD 15例，患儿于出生后6个月再次复查 头颅MRI，观察病灶演变情况，并在纠正 胎龄的情况下进行Gesell评分，观察不同 分型患儿的发育情况。结果 WMD患儿6个 月复查头颅MRI，结果显示弥漫性WMD、线 状和混合性WMD患儿的脑室旁白质软化、 脑室旁白质软化后遗症的发生率均显著的 高于点簇状患儿(P<0.05)；各种类型的 WMD复查脑外间隙增宽的发生率差异无统 计学意义(P>0.05)；弥漫性WMD、线状和 混合性WMD患儿的 Gesell评分中GMDQ、 FMDQ、ADQ评分均显著的低于点簇状患儿 (P<0.05)。结论 弥漫性WMD、线状和混合 性WMD患儿的预后较点簇状WMD患儿差。

Objective To investigate the relationship between the different subtypes of white matter damage (WMD) by routine Magnetic Resonance Imaging (MRI) examination and the prognosis of children. Methods 59 premature infant with asphyxia history in our hospital from January 2015 to June 2015 were selected. The children were given with MRI examination after 2 weeks born. There were 44 cases with focal WMD, 15 cases with diffuse WMD. The children were given with MRI again after 6 months born to observed lesion evolution. The Gesell score were observed under the corrected age. The development status of children with different types were observed and compared. Results The results of MRI after 6 months of born showed that there was periventricular leukomalacia in children with diffuse WMD, linear WMD and mixed WMD. The periventricular leukomalacia sequelae rate of children with diffuse WMD, linear WMD or mixed WMD were significantly higher than that of the children with point cluster WMD (P<0.05). The incidence of widening of the extra cerebral space was not statistically significant between children with different types of WMD(P>0.05). The GMDQ, FMDQ and ADQ scores in Gesell of children with diffuse WMD, linear WMD or mixed WMD were significantly lower than that of children with point cluster WMD(P<0.05). Conclusion The prognosis of children with diffuse WMD, linear WMD or mixed WMD is worse than that of children with clustered WMD.