SWI在早产儿缺血缺氧性脑损伤诊断中的临床应用

Clinical applications of susceptibility weighted imaging in the diagnosis of preterm infants with hypoxic-ischemic brain damage

目的:探讨磁共振磁敏感加权成像(SWI)在早产儿缺氧缺血性脑损伤(HIBD)临床诊断及分度中的临床应用价值。方法:选取经临床诊断为早产HIBD患儿30例,采用Siemens 3.0T超导型MR扫描仪,所有病例均行头颅常规序列及SWI扫描。比较常规MRI序列与SWI间差异,以及SWI扫描对轻、重度HIBD颅内出血灶、静脉扩张检出率的差异,分别进行非参数检验及卡方检验。结果:SWI检出患儿颅内出血灶数量多,在出血灶大小、范围及边界清晰度显示方面,SWI均明显优于MRI常规序列。SWI检出的颅内异常扩张静脉在MRI常规图像上未见显示。轻、重度早产HIBD患儿的颅内出血灶检出率差异具有统计学意义(χ2=4.464,P=0.035);颅内静脉扩张检出率差异有统计学意义(χ2=4.649,P=0.031),且重度HIBD患儿颅内出血合并静脉扩张的检出率高于轻度HIBD患儿(χ2=5.714,P=0.017)。结论:SWI对早产儿HIBD颅内出血、深静脉扩张的检出率高于常规MRI序列,可对早产儿HIBD临床分度提供影像学依据。

Objective：Our purpose of this study was to evaluate the clinical application values of susceptibility weighted imaging（SWI）in the diagnosis and grading of premature hypoxic-ischemic brain damage（HIBD）.Methods：Thirty preterm infants with HIBD diagnosed by pediatricians were collected and scanned by using Siemens 3.0Tsuperconducting MR scanner.Regular axial T1 WI,T2WI,FLAIR scan and axial SWI scan were conducted and their differences were compared.The difference of detection rates of intracranial hemorrhage and deep vein dilation in mild and severe HIBD were comparatively analyzed also by nonparametric test and Chi-square test.Results：Dilated deep veins,clearly showed on SWI,could not be displayed on regular sequences.The detection rates of intracranial hemorrhage were significant different withχ2=4.464,and P=0.035,in mild and severe HIBD infants.The detection rates of dilated cerebral veins was significant different too,withχ2=4.649,and P=0.031.And the detection of intracranial hemorrhage accompanied with dilated deep veins was significantly higher withχ2=5.714,P=0.017 in severe HIBD group.Conclusion：SWI was significantly superior to regular T1 WI,T2WI and FLAIR in displaying the size,scope and boundaries of hemorrhage.SWI sequence has higher sensitivity than conventional MRI sequences in detecting intracranial hemorrhage and dilated deep veins in HIBD,and can provide evidence for clinical grading for premature HIBD.