新生儿缺血缺氧性脑病CT及MRI诊断比较

Comparison of CT and MRI Diagnosis in Hypoxic-ischemic Encephalopathy of Neonates

目的分析比较CT及MRI诊断新生儿缺血缺氧性脑病(HIE)的价值。方法依据临床通用分度和影像学各自分度标准,回顾性分析60例HIE临床及CT、MRI资料,临床和影像分度符合率采用卡方检验,以P<0.05水准为统计学差异具有显著性。结果 60例均做了CT检查,其中25例同时行MRI检查。临床分度:轻度29例(48.3%),中度21例(35%),重度10例(16.7%);CT分度:正常7(11.7%)例,轻度24例(40%),中度20例(33.3%),重度9例(1 5%),显示颅内出血2 1例(35%)。HIE检出率88.3%。以临床分度为标准,CT诊断吻合率为82.4%,X2=10,P=0.019<0.05。MRI检查共25例:轻度12例(48%),中度9例(36%),重度4例(16%),显示颅内出血6例(24%)。HIE检出率100%,与临床分度吻合率达93.5%。复查CT对轻中度HIE显示率分别为6.5%、45%,MRI分别为25.3%、58.3%。结论 CT和MRI检查对HIE的早期诊断、分型及预后评估有重要价值,MRI优于CT;但蛛网膜下腔出血检出CT优于MRI。

Objective To compare the value of CT and MRI diagnosis of neonatal hypoxic-ischemic encephalopathy （HIE）. Methods Based on clinical and radiographic universal indexing standards, a retrospective analysis of 60 cases of HIE clinical and CT Mild data was analyzed, The clinical and imaging division compliance rate using the chi- square test, with P〈0.05 level for statistical learn the difference was significant. Results 60 cases were all underwent CT, while 25 patients underwent MI〈I. Clinical grading： 29 mild cases （48.3%） , 21 moderate cases （35%）, 10 severe cases （16.7%）; CT indexing： normal in 7 cases （11.7%）, nfild in 24 cases （40%）, moderate in 20 cases （33.3%）, and severe in 9 cases （15%）, 21 cases ofintracranial hemorrhage （35%）. HIE detection rate of 88.3%. According to clinical grading standard, CT diagnostic agreement was 82.4%, X^2 =10, P=O.（I19 〈0.（15. MRI examination of 25 cases： mild in 12 cases （48%）, moderate in 9 cases （36%）, severe in 4 cases （16%）, intracranial henmrrhage in 6 cases （24%）. HIE detection rate of 100%, consistent with the clinical grading by 93.5%. CT scan of mild to moderate HIE display rates were 6.5%, 45%, MRI were 25.3%, 58.3%. Conclusion CT and MRI have significant value in the early diagnosis, classification and prognosis of HIE, MRI is snperior to CT; But CT detection of subarachnoid hemorrhage is superior than MRI.