新生儿低血糖脑损伤的磁共振表现及弥散加权成像优势

The MRI finding of brain injury due to neonatal hypoglycemia and the superiority of diffusion-weighted imaging

目的探讨新生儿低血糖脑损伤的核磁共振成像(MRI)表现及磁共振弥散加权成像技术(DWI)优势。方法回顾性分析临床诊断为低血糖脑损伤的19例患者的MRI和DWI表现。。结果 19例患者中,18例顶枕叶皮质及皮质下白质受累,9例胼胝体受累,6例内囊后肢高信号消失,5例侧脑室旁脑白质受累,2例基底节受累,1例尾状核头部受累。所有患者DWI均可见异常(100%),但仅有48.4%于常规MRI序列表现为阳性。3个月后2例复查MRI,均发现双侧顶枕叶多发软化灶。结论低血糖脑损伤最常见的发生部位是大脑半球后部顶枕叶皮质及皮质下白质区;DWI扫描可以发现早期的低血糖脑损伤,较常规MRI更为敏感。

Objective To investigate the magnetic resonance imaging（MRI） findings of brain injury observed in neonatal patients who suffered from hypoglycemia and explore the value of diffusion-weighted imaging（DWI） in early detection of neonatal hypoglycemic brain injury.Methods To analyze the MRI and DWI of 19 neonates with hypoglycemia brain injury.Results 18 cases of infants had the parietal and occipital cortex and subcortical white matter abnormalities,9 cases had corpus callosum abnormalities,6 cases had an abnormal posterior limb of the internal capsule,5 cases had the periventricular white matter injury,2 cases had basal ganglia abnormalities,and 1 case had head of caudate nucleus abmormality.All of the DWI imaging had abnormalities,but only 48.4% infants had signal abnormalities on T1 and T2-weighted images.The followed-up MRI of 2 cases after three months showed that regional encephalomalacia was found in occipital and parieta lobes.Conclusion The most common and diagnostic area of brain injury of neonatal hepoglycemia is the parietal and occipital cortex and subcortical white matter.DWI scan can find early hypoglyomic brain damage,which is more sensitive than routine MRI.