目的 探讨CT与MRI在诊断新生儿 低血糖脑损伤中的价值。方法 回顾性分 析我院2015年1月-2017年1月收治的86例 低血糖患儿，分别应用CT、MRI检查，比 较CT、MRI典型影像学特点，分析其影响 因素。结果 MRI对低血糖脑内损伤检出 率显著高于CT(P<0.05)。MRI诊断良好率 显著高于CT(P<0.05)，中度、重度率低 于CT(P<0.05)，死亡诊断率比较无差异 (P>0.05)。CT典型影像学特点：病变区表 现为斑片状高密度影，6个月复检发现3例 患儿出现继发性脑积水，脑侧室内见等密 度。MRI典型影像学特点：患儿发生出血 2d后，影像表现为T1WI像等信号，T2WI像 呈现低信号；出血12d内，T1WIT1WI呈高 信号，T2WI像为低信号。T1WIT2WI13d以 后，出血区逐渐液化T1WI呈T1WI低信号， T2WIT2WI高信号。分娩方式、妊娠期高 血压与新生儿低血糖性脑损伤发生无关 (P>0.05)，伴糖尿病、早产/低产儿、首 次哺乳时间>24h、血糖<2.2mmol/L、低血 糖持续时间>24h是新生儿低血糖性脑损伤 的危险因素(P<0.05)。结论 MRI检测新生 儿低血糖脑损伤较CT诊断率高，能显著提 高脑损伤病灶检出率。

Objective To investigate the value of CT and MRI in detecting neonatal hypoglycemic brain injury. Methods of the imaging data of 35 neonatal hypoglycemia patients who underwent CT and MR examinations in our hospital from January 2015 to January 2017 were analyzed retrospectively. Then the typical imaging features of CT and MRI were compared and the influenced factors were analyzed. Results The MRI detecting rate of abnormal neonatal hypoglycemic brain injury was significantly higher than of CT (P<0.05), the good rate of MRI diagnosis was significantly higher than that of CT (P<0.05). While the detecting rate of moderate and severe neonatal hypoglycemic brain injury was significantly lower than of CT (P<0.05), no difference was found in the death diagnosis rate (P>0.05), the typical imaging features of CT including patchy clouding opacity, secondary hydrocephalus, iso density in the cerebral lateral chamber. The typical imaging features of MRI including low signal on T1 weighted image and high signal on T2 weighted image after the 2 days of hemorrhage; high signal on T1 weighted image and low signal on T2 weighted image within 12 days of hemorrhage; low signal on T1 weighted image and high signal on T2 weighted image after 13 days of hemorrhage. Mode of delivery and gestational hypertension were not correlated with neonatal hypoglycemic brain injury (P>0.05). Diabetes mellitus, premature infant / low birth weight infant children, first lactation time > 24h, blood glucose <2.2mmol/L and duration of hypoglycemia > 24h were the independent risk factors of neonatal hypoglycemic brain injury (P<0.05). Conclusion Compared with CT examination, MRI has a higher diagnostic rate of neonatal hypoglycemic brain injury, which can improve the detection rate of neonatal hypoglycemic brain injury.