磁共振弥散加权成像在新生儿早期缺氧缺血性脑病的临床应用

Clinical application of diffusion weighted magnetic resonance imaging in the early neonatal hypoxic ischemic encephalopathy

目的探讨磁共振弥散加权成像(DWI)在新生儿早期缺氧缺血性脑病(HIE)的应用及价值。方法收集本院经临床确诊为HIE共72例,对其进行常规T1W、T2W和DWI扫描,并对影像学进行分析,评价DWI在早期HIE的诊断优势。结果 DWI出现高信号病灶53例,T1W信号异常25例,T2W信号异常4例,其中DWI高信号病灶多见于大脑皮层、基底节区、侧脑室体旁及前后角周围白质区、半卵圆中心,T1W高信号以侧脑室周围白质区多见,出血性病变在T1W呈高信号而T2W和DWI表现为低或无信号。结论 DWI可作为HIE早期检测的重要手段,在显示病灶范围、数目等方面明显优于常规T1W、T2W,能对临床HIE早期诊断、早期干预治疗提供可靠的客观依据,对评估预后有重要价值。

[Abstract] Objective To investigate the value and application of diffusion weighted magnetic resonance imaging （DWI） in the early neonatal hypoxic ischemic encephalopathy （HIE）. Methods 72 patients with HIE diagnosed in our hospital were collected in this work. The conventional TlW, TzW and DWI scanning were performed, the radiographic findings were analyzed, and the advantage of DWI in the diagnosis of early HIE was evaluated. Results The DWI exhibited high signal lesions in 53 cases, T1WI appeared the signal abnormalities in 25 cases, and T2 W showed signal abnormalities in 4 cases. The DWI high signal lesions were mostly found in the cerebral cortex, the basal ganglia, the body of the lateral ven- tricle, the front and back angle of periventricular white matter areas, and the semiovale centrum. T1 WI high signal mostly occurred in periventricular white matter regions. Hemorrhagic lesions appeared hyperintensity on T1W and TaW and low or no signal on DWI. Conclusion DWI is an important means for early diagnosis of HIE, which can make up the conven- tional T1 W, T2 W deficiency, but, is relatively insensitive to hemorrhage.