DWI对足月新生儿缺氧缺血性脑病预后的评估价值

Prognostic value of DWI in term neonates with hypoxic ischemic encephalopathy

目的:探讨DWI对足月新生儿缺氧缺血性脑病(HIE)预后的预测价值。方法:选取71例临床诊断为HIE的足月新生儿,均行常规MRI及DWI扫描,测量ROI(半卵圆中心层面、放射冠层面深部白质、尾状核、豆状核、内囊前肢、内囊膝部、内囊后肢、背侧丘脑)的ADC值;并在患儿8个月时进行随访,采用贝利婴幼儿发育量表(BSID)进行发育评分。根据BSID评分结果将患儿分为预后良好组和预后不良组,比较2组ROI的ADC值差异,并绘制各ROI的ROC曲线,寻找评估HIE预后的最敏感部位。结果:预后良好组各ROI的ADC值均较预后不良组高;内囊后肢ROC的AUC最大,对HIE的预后评估更敏感。结论:DWI在HIE的预后评估中有重要价值。

Objective:To evaluate the prognostic value of DWI in term neonates with hypoxic ischemic encephalopathy(HIE).Methods:Routine MRI and DWI scans were performed on 71 full-term newborns clinically diagnosed with HIE to measure the ADC value of the ROI(deep white matter of centrum semiovale and corona radiata plane,caudate nucleus,lenticular nucleus,anterior limb of internal capsule,internal capsule knee,posterior limb of internal capsule and dorsal thalamus).The children were followed up at the age of 8 months,and neurobehavioral development scores were scored by bailey infant development scale(BSID).According to the score results of BSID,the children were divided into the group of good prognosis and the group of poor prognosis.The ADC difference in the ROI of the two groups was compared to see if there was any statistical significance.The ROC curve was drawn for each ROI to find the best cut-off value.Results:Compared with the poor prognosis group,the ADC value of neonatal HIE in the group of good prognosis was higher in the non-sympathetic ROI,and the AUC of the posterior limb of the inner sac was the largest.Compared with other parts,it was more sensitive to the prognosis prediction of HIE.Conclusion:DWI is of great value in predicting the prognosis of neonatal HIE at term.