增强T2＊加权血管成像在缺氧缺血性脑病足月新生儿颅内深静脉显示的价值

Value of enhanced T2＊-weighted angiography in the intracranial deep vein display in full-term neonates with hypoxic-ischemic encephalopathy

目的 探讨增强T2＊加权血管成像（ESWAN）序列显示缺氧缺血性脑病（HIE）足月新生儿颅内深静脉扩张的价值.方法 将临床确诊为HIE的足月新生儿32例和健康足月新生儿10例行头颅磁共振成像（MRI） ESWAN序列扫描.分别统计健康对照组与HIE轻、中、重度组颅内深静脉的显示率;比较健康对照组与HIE轻、中、重组及HIE轻、中、重组组间颅内深静脉显示率的差异;观察HIE组颅内缺血灶与颅内深静脉的关系.评价ESWAN序列在HIE诊断中的作用.结果 健康对照组颅内深静脉显示率为26.2％（21/80例）,HIE轻、中、重度组显示率分别为59.8％（67/112例）、92.3％（96/104例）、95.0％（38/40例）;健康对照组与HIE轻度组颅内深静脉显示率差异有统计学意义（P＜0.05）;HIE轻度组与中度组组间比较,差异有统计学意义（P ＜0.05）;HIE中度与例重度组组间比较,差异无统计学意义（P ＞0.05）;HIE组扩张颅内深静脉与缺血灶分布一致.结论 ESWAN序列能清晰显示扩张深静脉与缺血灶的关系,对判断HIE部位与范围有一定的诊断价值;所显示继发的颅内深静脉的扩张状况,可提示HIE的严重程度.

Objective To explore the value of enhanced T2 ＊-weighted angiography （ESWAN） sequence in displaying the intracranial deep vein distension in full-term neonates with hypoxic-ischemic encephalopathy （HIE）.Methods Thirty-two confirmed cases of full-term neonates confirmed with HIE and 10 cases of normal full-term neonates received the brain magnetic resonance imaging（MRI） ESWAN sequence scanning.The display rate of intracranial deep vein in normal group and HIE group with mild,moderate and severe degree was evaluated.The differences in intracranial deep vein display rate between the normal group and the HIE group or within different degrees of HIE patients were compared respectively to observe the relationships between intracranial ischemic lesion and deep vein conditions.The role of ESWAN sequence in the diagnosis of HIE was evaluated.Results The display rate of intracranial deep vein in normal group was 26.2％ （21/80 cases） ;the display rate of intracranial deep vein in mild,moderate and severe HIE groups were 59.8％ （67/112 cases）,92.3％ （96/104 cases） and 95.0％ （38/40 cases）,respectively.The differences of intracranial deep vein display rate between normal group and mild HIE group were statistically significant （P ＜ 0.05） ; the differences of intracranial deep vein display rate between the slight HIE group and moderate HIE group were statistically significant （P ＜ 0.05） ;the differences of intracranial deep vein display rate between the moderate HIE group and severe HIE group were not statistically significant（P ＞ 0.05）.The distribution of intracranial deep vein distension and ischemic lesion in HIE group was consistent.Conclusions ESWAN sequence can clearly show the relationship between intracranial venous distension and ischemic lesion,which has diagnostic value in judging the location and extent of HIE.It can indicate the severity of HIE by displaying secondary distension of intracranial vein.