3.0T磁共振对新生儿HIE诊断价值和检查序列优化

Value of 3.0T Magnetic Resonance Imaging in the Diagnosis of Neonatal HIE and Optimization of Examination Sequence

目的：评价磁共振扩散加权成像（DWI）和常规序列对新生儿缺氧性脑损伤（非出血灶）的诊断价值,优化磁共振检查序列。方法：54例出生1-14 d临床确诊HIE患儿,分1-7 d患儿和8-14 d患儿,均行3.0T磁共振T1WI、T2WI、FLAIR、DWI扫描,两位磁共振诊断医师采用双盲法观察并记录DWI、T1WI、T2WI和FLAIR图像病灶数目,用秩和检验统计方法,对比分析DWI与常规序列对病灶检出情况,P〈0.05为差异有统计学意义。结果：出生1-7 d患儿,DWI、T1WI、T2WI、FLAIR检出缺氧性脑损伤病灶分别为196、225、28、365个,平均秩次分别为2.85、2.40、1.29、3.46,Z=60.76,P=0.000。出生8-14 d患儿,DWI、T1WI、T2WI、FLAIR检出缺氧性脑损伤病灶分别为70、141、32、214个,平均秩次分别为1.86、2.89、1.50、3.75,Z=36.34,P=0.000。结论：磁共振DWI联合常规序列对新生儿缺氧性脑损伤具有重要价值,最优化的检查序列DWI、T1WI、FLAIR联合应用。

Objective： To evaluate the diagnostic value of the magnetic resonance （ MRI ） diffusion weighted imaging （ DWI ） and T1WI. T2WI. FLAIR in the diagnosis evaluation of hypoxic-ischemic encephalopathy （ HIE ）, optimizing examination process of magnetic resonance.Method： A total of 54 neonatal clinical definited HIE including 1-14 days age were examined using DWI and routine T1WI, T2WI, FLAIR of 3.0T MR, 54 neonatal divided into 1-7 days age and 8-14 days age, the brain injury lesion in T1WI, T2WI, FLAIR, DWI were diagnosed by two senior radioloists, the contrastive analysis of DWI, T1WI, T2WI, FLAIR findings were tested by using Wilcoxon rank sum test.P〈O.05 was considered as statistical.Result：In 36 cases of 1-7 days, 196 brain injury lesions were found by DWI and 225 brain injury lesions by T1WI, 28 brain injury lesions by T2WI, 365 brain injury lesions by FLAIR.Mean rank order of DWI, T1WI, T2WI, FLAIR were 2.85, 2.40, 1.29, 3.46, Z=60.76, P=0.O00.In 18 cases of 8-14 days age, 70 brain injury lesions were found by DWI and 141 brain injury lesions by T1WI, 32 brain injury lesions by T2WI, 214 brain injury lesions by FLAIR.Mean rank order of DWI, T1WI, T2WI, FLAIR were 1.86, 2.89, 1.50, 3.75, Z=36.34, P=0.0OO.Conelusion： Magnetic resonance DWI combiened with conventional MRI is important in the diagnosis evaluation of neonatal HIE, the optimal sequence of MRI is DWI and T1WI, FLAIR combined application.