新生儿窒息早期的MRI表现及与预后的关系

Neonatal asphyxia: early MRI findings and its correlation with prognosis

目的 探讨新生儿窒息早期的MRI表现及其与预后的关系。方法 回顾性分析 80例以新生儿窒息住院的患儿初期的MRI表现及 2 6例复查病例的MRI表现。结果 80例根据MRI表现分为 5组 :A组 :MRI无异常发现 ,15例 ;B组 :小范围脑水肿 12例 ;C组 :T1WI呈点状和弯曲条状高信号 8例 ;D组 :大面积的脑水肿 12例 ;E组 :其他病变及以上 3组不同程度病变的组合 33例。A组复查 3例及B、C组各复查 5例 ,仅C组 1例发现异常征象 ;D组复查 4例均出现明显的异常征象 ;E组复查 9例 ,7例发现异常MRI征象。结论 MRI可以客观地反映新生儿窒息后脑损伤的情况 ,并且可以早期评估预后。

Objective To investigate the early MRI findings of neonatal asphyxia and its correlation with prognosis. Methods Early MRI findings of neonatal asphyxia in 80 cases and follow up MRI findings in 26 cases were reviewed retrospectively. Results Fifteen patients had normal MR findings(group A), and the remaining 65 patients were divided into four groups based on patterns of injury: small area of brain edema in 12 cases (group B); streak like and spotty hyperintensities in 8 cases On T 1WI (group C); large area of brain edema in 12 cases (group D); and mixed injury pattern in 33 cases (group E). Follow up MRI scans in group A (3 cases), B (5 cases), and C (5 cases) was performed, and only 1 case in group C showed abnormalities. Follow up scans in 4 cases of group D revealed abnormalities, and 7 out of 9 cases in group E found abnormalities. Conclusion MRI can show the brain damage in asphyxiated neonates objectively during the first week of life, and estimate the prognosis at the early stage.