常规MRI及DWI在新生儿低血糖脑损伤评估中的初步研究

Application of MRI/DWI in brain injury of infants of diabetic mothers

目的:分析妊娠期糖尿病母亲分娩的足月低血糖新生儿脑损伤的常规磁共振和磁共振扩散加权成像(DWI)的特征。方法:随机回顾性分析妊娠期糖尿病母亲所分娩的足月低血糖新生儿48例,对患儿行动态血糖检测、常规MRI及DWI检查。对照分析血糖水平与影像学特征之间的关系。结果:常规MRI显示脑内异常信号8例(16.7%,8/48),11例(18.8%,11/48)DWI显示脑内异常信号,病灶部位均以顶、枕叶为著。反复发作性低血糖的脑损伤发生率高于短暂性低血糖(P<0.05)。有症状低血糖患儿比无症状低血糖患儿的脑损伤发生率高,两者差异有统计学意义(P<0.05)。结论:新生儿低血糖持续时间和程度与脑损伤密切相关,MRI特别是DWI对新生儿低血糖脑损伤可作出早期诊断和预后评估。

Objective.. To investigate the features of brain injury of infants of diabetic mothers in conventional MRI and diffusion weighted imaging （DWI）. Methods： Forty-eight tern, newhorn of diabetic mothers were studied retrospectively. The blood glucose level of infants was recorded dynamically. MRI and DWl were carried out to evaluate the brain injury. Results： Eight （16.7 ± ,8/48） patients were found abnormal signal lesions on conventional T： W1 and T2 WI. 11 of all patients （18. 8% ） were discovered lesions on DWI. Most of the lesions localized in parietal and occipital lobes. The incidence of brain injury of infants with recurrent hypoglycemia was higher than that of infants with transient hypoglycemia （ P 〈0.05）. The incidence of brain injury of infants with symptoms was higher than that of infants without symptoms （ P 〈0.05）. Cnnclusion：The time length of hypoglycemia is corresponding closely with brain injury. MRI, especially DWI are helpful in diagnosing and assessing the prognosis.