1H-MRS和临床相关因素在新生儿脑白质弥漫性高信号诊断中的应用价值

Applications of 1H-MRS and clinical relative factors in diagnosis of neonatal cerebral white matter diffuse excessive high signal intensity

目的运用单体素氢质子波谱技术(1H-MRS)观察新生儿脑白质弥漫性高信号(DEHSI)成像特点,探讨DEHSI的演变规律及诊断价值。材料与方法对95名新生儿运用点分辨波谱序列对其脑组织兴趣区所得代谢数据进行分析研究。结果生后年龄、胎龄、头围均与DEHSI评估之间呈显著负相关(r=-0.398、r=-0.390、r=-0.269,P值均<0.05)。胎龄、生后年龄与NAA/Cr(r=0.386、r=0.328,P值均<0.05),NAA/Cho(r=0.432、r=0.367,P值均<0.05)呈正相关,与Cho/Cr(r=-0.204、r=-0.211,P值均<0.05),MI/Cr(r=-0.243、r=-0.286,P值均<0.05)呈负相关。此外,随着DEHSI的程度增加,NAA浓度,NAA/Cr和NAA/Cho比值下降(r=-0.320、r=-0.394、r=-0.565,P值均<0.05),而Cho/Cr和MI/Cr增加(r=0.389、r=0.376,P值均<0.05)。单因素方差分析:与正常组相比,轻度DEHSI组及中重度DEHSI组Cho/Cr和MI/Cr比值显著升高(P值均<0.05),而NAA/Cr、NAA/Cho比值显著下降(P值均<0.05)。结论生后年龄、胎龄、头围与DEHSI评估之间呈负相关;胎龄及生后年龄与新生儿脑组织代谢物水平有关;胎龄越大,胎儿越成熟,DEHSI分级越低,NAA浓度升高。

Objective： Use proton magnetic resonance spectroscopy （1H-MRS） to observe the imaging features in neonatal cerebral white matter diffuse excessive high signal （DEHSI） and explore the evolution of DEHSI and diagnostic value. Materials and Methods：This study included 95 neonates, using MRS for the study of the region of interest in cerebral white matter lesions. Results：Postnatal age, gestational age, and head girth had significantly negative correlation with DEHSI （r=-0.398, r=-0.390, r=-0.269, all P〈0.05）. Gestational age and postnatal age with the ratios of NAA/Cr （r=0.386, r=0.328, all P〈0.05）, and NAA/Cho （r=0.432, r=0.367, all P〈0.05） were discovered with a clearly positive signiifcant difference and a marked negatively correlated with the values Cho/Cr （r=-0.204, r=-0.211, all P〈0.05）, and MI/Cr （r=-0.243, r=-0.286, all P〈0.05）. In addition, the increasing extent of DEHSI was associated with a signiifcant decrease in NAA concentration, NAA/Cr in relation to NAA/Cho （r=-0.320, r=-0.394, r=-0.565, all P〈0.05）, resulting in an increase in Cho/Cr and MI/Cr （r=0.389, r=0.376, all P〈0.05）. Compared with control group, Cho/Cr and MI/Cr were signiifcantly elevated, whereas NAA/Cr and NAA/Cho ratios were signiifcantly decreased in infants with mild DEHSI and moderate-sereve DEHSI （all P〈0.05）.