DWI联合血清NSE检测在诊断早产儿局灶性脑白质损伤中的应用

Application of DWI Combined with Serum NSE Detection in the Diagnosis of Punctate white Matter Lesions in Premature Infants

目的探讨扩散加权成像(DWI联合血清神经元特异性烯醇化酶(NSE)检测在诊断早产儿局灶性脑白质损伤中的应用价值。方法选取2016年5月-2018年5月本院收治的92例局灶性脑白质损伤早产儿(纳为观察组)和同期在本院出生的无脑损伤的35名早产儿(纳为对照组)为研究对象,两组均行DWI扫描检查,检测两组早产儿出生当天、出生第1周、2周血清NSE水平,将观察组患儿依据病情严重程度分为轻度组、中度组和重度组,比较三亚组出生当天、出生第1周、2周血清NSE水平,ROC曲线评估DWI联合血清NSE检测在诊断早产儿局灶性脑白质损伤中的效能。结果两组出生后各时间点的NSE水平依次明显降低,并且观察组出生当天、出生后第1周、第2周NSE水平较对照组明显高,差异有统计学意义(P<0.05);局灶性脑白质损伤早产儿随着疾病程度加重,其血清中NSE水平明显升高(P<0.05),轻度组、中度组、重度组早产儿出生当天、出生后第1周、出生后第2周NSE依次明显降低,有统计学意义(P<0.05);DWI联合血清NSE检测诊断早产儿局灶性脑白质损伤的灵敏度、特异度、准确度和AUC较DWI、血清NSE明显高(P<0.05)。结论DWI联合血清NSE检测在诊断早产儿局灶性脑白质损伤中有明确应用价值,两者联合应用可作为诊断早产儿局灶性脑白质损伤和评估脑损伤严重程度的有效手段。

Objective To explore the application value of diffusion-weighted imaging(DWI)combined with serum neuron specific enolase(NSE)in the diagnosis of punctate white matter lesions in premature infants.Methods A total of 92 premature infants with punctate white matter lesions(included in observation group)and 35 premature infants born without punctate white matter lesions(included in control group)in our hospital from May 2016 to May 2018 were selected for the study.The two groups were given DWI scanning to detect the serum NSE levels on the day of birth and at the 1 st w and 2 nd w of birth in the two groups.The children patients in observation group were divided into mild group,moderate group and severe group according to the severity of disease.The serum NSE levels on the day of birth and at the 1 st w and 2 nd w of birth were compared among the three subgroups.The ROC curve was used to evaluate the efficacy of DWI combined with serum NSE in the diagnosis of punctate white matter lesions in premature infants.Results The NSE level at the time points after birth was successively decreased significantly in the two groups,and the NSE level in observation group on the day of birth and at the 1 st w and 2 nd w of birth was significantly higher than that in control group(P<0.05).With the exacerbation of severity of punctate white matter lesions in premature infants,the serum NSE level was significantly increased(P<0.05),and the NSE was successively decreased significantly in mild group,moderate group and severe group on the day of birth and at the 1 st w and 2 nd w of birth(P<0.05).The sensitivity,specificity,accuracy and AUC of DWI combined with serum NSE in the diagnosis of punctate white matter lesions in premature infants were significantly higher than those of DWI and serum NSE(P<0.05).Conclusion DWI combined with serum NSE has clear application value in the diagnosis of punctate white matter lesions in premature infants.The combination of the two can be used as an effective means to diagnose punctate white matter lesions in premature infants and to assess the severity of brain injury.