弥散加权成像对新生儿脑损伤的早期诊断价值

Early diagnostic value of diffusion-weighted imaging in neonatal cerebral damage

目的分析磁共振弥散加权成像（DWI）图像与常规MRIT1WI、他wI图像，以期得出早期诊断新生儿脑损伤最适宜DWI的检测时间。方法对2011年4月至2012年1月太钢总医院进行磁共振检查DWI阳性并临床确诊脑损伤的82例新生儿的影像学资料进行回顾性分析。结果HIE患儿中日龄≤3d进行MRI检查者86％DWI可见高信号，T1WI、T2WI阴性或异常信号范围较小；日龄4-7d进行MRI检查者77％DWI可见高信号，T1研、12WI阴性或异常信号范围较小；日龄〉7d进行M砌检查者仅20％DWI表现为高信号的范围较T1WI及T2WI广。低血糖脑损伤患儿中，发现低血糖后3d内进行MRI检查者均为DWI可见高信号，T1可以及T2WI阴性；发现低血糖4～7d检查者75％DWI可见高信号，T1WI及12WI阴性。早产儿局限性脑白质损伤患儿中日龄4～7d检查者均为DWI可见高信号，T1WI及，12w阴性。结论新生儿早期（7d前）进行DWI检查能为早期诊断新生儿脑损伤提供可靠的客观依据。

Objective By using the diffusion-weighted imaging （DW!） technique associated with the routine MR T1WI and T2WI, to study the best time of checking DWI in neonatal cerebral dam- age. Methods During April 2011 and January 2012, 82 eases of neonatal clinical definited cerebral damage were examined by DWI and routine T1WI,T2WI. Results In all these HIE cases, which were checked in 3 days 86% had high signal intensity （SI） on DWI sequences, both T1WIand T2WI showed normal signals. Which were checked in 4 -7 days 77 % had high SI on DWI sequences. After 7 days, 20% had high SI on DWI sequences. In hypoglyeemic brain damage cases, which checked in 3 days af- ter hypoglycemia onset, 100% had high SI on DWI sequences, both T1WI and T2WI showed normal sig- nals. Which checked in 4 - 7 days after hypoglycemia onset, 77% had high SI on DWI sequences, both T1WI and T2WI showed normal signals. In the preterm infants with early cerebral white matter damage, which checked in 4 -7 days 100% had high SI on DWI sequences, both T1WI and T2WI showed normal signals. Conclusions DWI which were checked in 7 days can provide reliable clinical evidence for neo- natal cerebral damage.