目的 采用Meta分析综合定量 评价MR弥散张量成像对缺氧缺血性脑病 的诊断价值。方法 检索美国医学索引 Medline、Ovid、Springer、Elsevier、 Lippincott Williams＆Wilkins(Lww)数 据库及中国期刊网国内文献库(CNKI)1997 年1月至2016年12月公开发表的中英文 文献，分析软件为RevMan 5.3，合并 效应量为加权均数差(weighted mean difference，WMD)。结果 纳入研究DTI诊 断HIE的文献共13篇。结果显示：(1)轻、 中、重度HIE组新生儿内囊后肢、胼胝体 膝部、压部各向异性分数(fractional anisotropy，FA)值比对照组新生儿低， 其中内囊后肢WMD及95%CI为-0.04(- 0.06，-0.02)、-0.07(-0.10，-0.03)、- 0.07(-0.10，-0.03)；胼胝体压部WMD及 95%CI为-0.09(-0.10，-0.07)、-0.09(- 0.12，-0.06)、-0.19(-0.33，-0.05)； 胼胝体膝部WMD及95%CI为-0.06(-009，- 0.03)、-0.07(-0.10，-0.05)、-0.13(- 0.21，-0.06)。(2)轻度HIE组新生儿在顶 叶白质、额叶白质区FA值与对照组新生儿 相比无统计学意义；中重度组FA值比对照 组新生儿低。(3)豆状核、丘脑、尾状核 及放射冠区FA值与对照组新生儿相比无 统计学意义。结论 内囊后肢、胼胝体压 部及膝部是HIE受累最明显的部位；其FA 值降低可为HIE的早期诊断提供影像学依 据。

Objective To evaluate the value of MR diffusion tensor imaging in the diagnosis of hypoxic - ischemic -cephalopathy by Meta- analysis. Methods Searching the related literatures in Medline, Ovid, Springer, Elsevier, Lippincott Williams＆Wilkins (Lww) and the Chinese Journal Net (CNKI) from January 1997 to December 2016, analysis software for the RevMan 5.3, the combined effect was the weighted average difference (WMD). Results A total of 13 articles were included in the study of DTI diagnosis of HIE. The results showed that: (1) The FA value of the posterior limb of internal capsule, the plenium and genu of corpus callosum in the neonates with mild, moderate and severe HIE were lower than that in the control group of which the value of WMD and 95% CI in the posterior limb of Internal capsule were -0.04 (-0.06, -0.02), -0.07 (-0.10, -0.03), -0.07(-0.10,-0.03), of which the value of WMD and 95% CI in the Splenium of corpus callosum were -0.09(-0.10,-0.07), -0.09(-0.12,-0.06), -0.19(-0.33,-0.05); of which the value of WMD and 95% CI in the Genu of corpus callosum were -0.06(-009,-0.03), -0.07(-0.10,-0.05), -0.13(-0.21,-0.06). (2)There was no significant difference in the FA value of the Parietal white matter, frontal white matter in neonates with mild HIE group compared with the control group. The FA value of moderate to severe group was lower than that of control group.(3) There were no statistically significant in comparing the FA value of lentiform nucleus, thalamus, caudate nucleus and radiation crown with neonatal control group. Conclusion The posterior limb of internal capsule, the splenium and genu of corpus callosum were the most obvious parts of HIE involvement. The decrease of FA value can provide imaging basis for the early diagnosis of HIE.