足月新生儿缺氧缺血性脑病的早期头颅MRI分度诊断与临床分度诊断符合率比较

Comparisons of coincidence rate of early cranial MRI grading diagnosis and clinical grading diagnosis in full-term neonates with hypoxic-ischemic encephalopathy

目的探讨头颅磁共振(MRI)检查对新生儿早期缺氧缺血性脑病(HIE)的分度诊断价值。方法 372例临床诊断为HIE的足月新生儿,均于出生早期行头颅MRI检查,观察并比较HIE患儿临床诊断及MRI诊断分度情况。结果 372例HIE患儿,临床诊断为轻度208例,中度136例,重度28例;头颅MRI诊断为正常6例,轻度204例,中度128例,重度34例。MRI分度诊断对于轻度、中度与共同分度诊断符合率较高,临床分度诊断重度与共同分度诊断符合率较高,但比较差异无统计学意义(P>0.05)。结论头颅MRI对HIE的分度诊断与临床分度诊断有较高的符合率, MRI属无创性检查,对患儿临床的治疗和预后的判断有较好的指导意义,是临床诊断HIE的重要辅助检查。

Objective To discuss the grading diagnosis value of magnetic resonance imaging for early neonatal hypoxic-ischemic encephalopathy (HIE). Methods A total of 372 full-term neonates with HIE were examined by cranial MRI at the early stage of birth. The clinical diagnosis and the grading of MRI diagnosis of HIE were observed and compared. Results Among 372 HIE neonates, there were 208 mild cases, 136 moderate cases and 28 severe cases by clinical diagnosis. There were 6 normal cases, 204 mild cases, 128 moderate cases and 34 severe cases by cranial MRI diagnosis. The coincidence rate of MRI grading diagnosis for mild, moderate and common HIE grading was higher, and clinical grading diagnosis for severe and common HIE grading was higher, but the difference was not statistically significant (P>0.05). Conclusion Cranial MRI has a high coincidence rate between grading diagnosis and clinical grading diagnosis of HIE. It is a non-invasive examination, and has a good guiding significance for clinical treatment and prognostic judgement of children. It is an important auxiliary examination for clinical diagnosis of HIE.