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·头颈疾病·

各向异性分数在新生儿缺血缺氧性脑病早期诊断的应用

作者:郑健辉 卢瑞沾 莫秀凤 黄飞文 梁燕斌

所属单位:暨南大学附属江门五邑中医院影像科 (广东 江门 529031)

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摘要

目的 探讨扩散张量成像(DTI)技术特征参数各向异性分数(FA值)在评价新生儿缺血缺氧性脑病的临床应用价值。 方法 选取32例检查者(轻度组6例,中度组5例,对照组15例,疑似组6例)分组进行常规磁共振和扩散张量成像 检查,测量各组感兴趣区域FA值并进行统计学分析。结果 常规磁共振检查:轻度组、中度组和对照组符合临床诊 断,疑似组未发现异常信号;测量FA值:轻度组、中度组比对照组FA值明显降低(P<0.05),轻度组与中度组之 间无明显差异(P>0.05),疑似组有两例FA值在轻度组与中度组参考值之间,有四例FA值与对照组参考值想接 近。诊断疑似组有两例脑部功能损伤。结论 磁共振扩散张量成像FA值在新生儿缺血缺氧性脑病的早期诊断能为临 床的诊疗提供更早的影像信息。

Objective To determine the medical practice value of fractional anisotropy (FA) in neonatal brain injury. Methods 32 infants with HIE (including mild group in 6, moderate group in 5, control group in 15 and suspected group in 6) were studied. Each group was examined with conventional MR imaging and diffusion-tensor MR imaging to analyze FA value in regions of interest. Results Conventional MR imaging results: the mild group, moderate group and control group adjust to clinical diagnosis, the suspecd group haven’t detect abnormal signal. FA values in mild group and moderate group were significantly lower than in control group (PA<0.05). There were no statistically differences between mild group and moderate group (P<0.05). FA values of two patients in suspected group ranged between mild group and moderate group, while FA values of other four patients in suspected group were not statistically significant. Two neonates in suspected group wee confirmed as neonatal brain injury. Conclusion FA values can be obtained as an objective basis for neonatal brain injury early diagnosis.

【关键词】缺血缺氧性脑病;扩散张量成像;各向异性分数

【中图分类号】R722

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2015.06.003

前言

新生儿缺血缺氧性脑病是脑部功能受损的重要 原因之一。轻者可治愈,重者可导致其智力低下、 发育落后、脑瘫、癫痫、甚至死亡[1]。早发现、早诊 断、早治疗能有效降低致残率,也有利于确定患儿以 后的康复治疗计划。常规磁共振成像是脑功能损伤辅 助检查的首选,但只能明确脑损伤的范围和程度, 却无法提供早期脑损伤的信息,降低磁共振对其早 期诊断的意义。而扩散张量成像(diffusion tensor imaging,DTI)在一定程度上可以无创性反映活体脑 白质纤维束的完整程度,并且对发现脑白质损伤比常 规磁共振检查敏感[2]。此次通过32例检查者分组进行 常规磁共振和扩散张量成像检查及比较,探讨DTI技术在新生儿缺血缺氧性脑病早期诊断的优势。