磁共振梯度回波T2*WI与磁敏感加权血管成像序列对新生儿颅内出血的诊断价值

Comparative analysis of T1WI,T2*WI and susceptibility weighted angiography imaging sequence in the diagnosis of neonatal intracranial hemorrhage

目的探讨磁共振成像技术T1WI与梯度回波T2*WI和磁敏感加权血管成像(SWAN)序列在新生儿颅内出血中的诊断价值。方法选择2012年12月至2014年1月北京军区总医院八一儿童医院新生儿重症监护病房收治并怀疑颅内出血的患儿行头颅磁共振(MR)检查。在T1WI检出高信号病灶时,加扫T2*WI或SWAN序列,表现为明显低信号的病灶认为是真实的出血灶,记录颅内出血病例数、出血灶的部位及数目。按照出血灶的位置,比较T1WI与T2*WI或SWAN序列对出血灶的检出能力。结果共入组58例,其中早产儿24例,足月儿34例。58例新生儿中经T2*WI和SWAN证实为新生儿颅内出血43例(74.1%),非颅内出血15例(25.9%)。43例颅内出血患儿中共检出出血灶508个,其中T1WI只检出283个出血灶,配对t检验证实T2*WI、SWAN对于出血灶的检出能力高于T1WI,差异有统计学意义(P<0.05)。结论 T2*WI或SWAN比常规MR在新生儿各种类型颅内出血灶的检出能力上具有明显优势,对诊断和鉴别颅内出血有意义。

Objective To evaluate the diagnostic value of T1 WI,T2＊WI and susceptibility weighted angiography（ SWAN） imaging sequence in neonatal intracranial hemorrhage. Methods Neonates with suspected intracranial hemorrhage admitted to the NICU of BAYI children＇ s hospital from December 2012 to January 2014 were enrolled and underwent cranial MRI. T2＊WI or SWAN sequence was applied when high-intensity signal lesion shown on T1 WI. Lesions with significantly low-intensity signal were considered real hemorrhage. The number of neonates,the locations of lesions and the number of hemorrhage were recorded. Then the diagnostic values of T1 WI,T2＊WI and SWAN sequences for different locations of hemorrhage were compared. Results A total of 58 cases were enrolled,including24 premature neonates and 34 full-term infants. 43 cases（ 74. 1%） were confirmed of neonatal intracranial hemorrhage by T2＊WI and SWAN,and the other 15（ 25. 9%） not. A total of 508 locations of hemorrhage were detected using T2＊WI and SWAN with only 283 locations on T1 WI. T2＊WI and SWAN were significantly more sensitive than T1 WI in detecting hemorrhage as paired t-test showed（ P 〈0. 05）.Conclusions T2＊WI and SWAN have more advantages than conventional MRI for the detection of various types of neonatal intracranial hemorrhage,and are useful for the diagnosis of intracranial hemorrhage.