弥散张量成像在足月新生儿缺氧缺血性脑损伤中的应用

Clinical significance of diffusion tensor imaging in hypoxic ischemic brain injury in full-term neonates

目的探讨弥散张量成像(DTI)评价足月新生儿缺氧缺血性脑损伤的可行性及其应用价值。方法应用DTI序列,结合常规MRI及DWI序列,比较50例具有不同程度(轻度、中度、重度)脑损伤的足月新生儿颅内6个感兴趣区(ROI)的异性分数(FA)值变化情况,并分析FA值与临床新生儿行为神经测查方法(NBNA)评分的相关性。结果 3个不同程度脑损伤组间脑内不同区域FA值差异有统计学意义,多重比较发现中度与重度脑损伤组间左侧颞叶白质的FA值差异无统计学意义,余脑损伤组间不同部位脑组织的FA值差异均有统计学意义,脑损伤越严重,FA值降低越明显。各ROI相应的FA值与NBNA评分均呈正相关。结论 DTI可应用于足月新生儿缺氧缺血性脑损伤的评估,FA值能精确地反映分子的弥散程度。

Objective To evaluate the feasibility and application of diffusion tensor imaging（DTI） in hypoxic ischemic brain injury in full-term neonates.Methods Bilateral fractional atrophy（FA） values of each region of interest（ROI） in 50 full-term neonates with different degree brain injury were assessed using DTI combined with conventional MRI and DWI sequence.The correlation between FA value and neonatal behavioral neurological assessment（NBNA） score was analyzed.Results FA values were significantly different among three groups of neonates with different degreed brain injury.Except for the FA value in left temporal white matter between moderate and severe brain injury group,there were significant differences revealed in FA values in each ROI among the 3 groups according to further multiple analysis.There was a significant positive correlation between FA value and NBNA score.Conclusion DTI can be used to study hypoxic ischemic brain injury in full-term neonates,using which FA value reflects the degree of molecular diffusion accurately.