成人心肺复苏后缺血缺氧性脑病的MRI表现与分型

MRI Characteristics and Classification for Adult Hypoxic-Ischemic Encephalopathy After Cardiopulmonary Resuscitation

目的研究成人心肺复苏后缺血缺氧性脑病MRI表现并根据其特征进行分型。方法回顾分析4家医院38例临床诊断为成人心肺复苏后缺血缺氧性脑病患者的临床资料和MRI影像资料。结果男20例,女18例,年龄18~75岁,平均38岁。患者因各种病因导致呼吸心跳骤停行心肺复苏后予以MRI检查。根据MRI表现分为5种脑损伤模式：脑室周围白质损伤型2例（5.3%）,深部灰质损伤型8例（21.1%）,分水岭区损伤型3例（7.9%）,中央沟周围皮质损伤型2例（5.3%）和混合型23例（60.5%）。混合型损伤包括上述的两种或两种以上的损伤类型。结论成人心肺复苏后缺血缺氧性脑病的MRI表现的5种损伤模式可反映缺血缺氧的严重程度和持续时间,可为临床诊断和预后评估提供有价值的信息。

Objective To study brain MRI characteristics of adult hypoxic-ischemic encephalopathy after cardiopuhnonai7 resuscitation,and to classify them according to MRI findings. Methods Clinical data and MRI image data of 38 adults clinically diagnosed with adult hypoxic-ischemic encephalopathy after cardiopulmonary resuscitation at four university hospitals were retrospectively analyzed. Results Among this group of＂ patients ,20 were male and 18 were t}emale. Their ages ranged from 18 to 75 years with an average of 38 years. Brain MRI was performed on all 38 patients after successful cardiopulmonary resuscitation tbr cardiac arrest caused by various conditions. There were five different patterns of MRI ap- pearances ： the pcriventricular white matter damage pattern in 2 cases （5.3%）, and the deep gray matter damage pattern in 8 cases （21.1%） ,and the watershed zone damage pattern in 3 case （7.8%） ,and the perineural cortex damage pattern in 2 cases （5.3%） and the mixed damage pattern in 23 case （60.5%）. The mixed damage pattern combined two or more of the patterns mentioned above. Conclusion The five patterns of MRI appearances for adult hypoxic-ischemie encephalop- athy after cardiopuhnonary resuscitation could reflect the severity and duration of the hypoxia-ischemia brain damage, and provide valuable information for the diagnosis and prognosis of hypoxic-ischemic encephalopathy in adults.