常规MRI联合DWI在评估足月HIE严重程度中的应用观察

Application of Routine MRI Combined with DWI in Evaluating the Severity of Full-Term HIE

目的观察常规磁共振成像(MRI)联合弥散加权成像(DWI)在评估足月新生儿缺血缺氧性脑病(HIE)严重程度中的应用价值。方法选取我院96例足月HIE新生儿进行回顾性分析,将日龄<7d者与日龄7~28d者分别按照病情程度分为轻度组、中度组与重度组,并取同期50例足月新生儿(均无窒息史)纳入对照组,均接受常规MRI与DWI检查,比较日龄<7d、日龄7~28d患儿中不同病情程度组与相应日龄对照组感兴趣区(ROI)表观弥散系数(ADC)。结果轻度组1、中度组1、重度组1顶叶白质与额叶白质ADC明显低于对照组1(P<0.05);中度组1、重度组1放射冠ADC明显低于轻度组1、对照组1(P<0.05);重度组1侧脑室旁白质、内囊后肢ADC明显低于其他3组(P<0.05),中度组1内囊后肢ADC明显低于对照组1(P<0.05);重度组1丘脑腹外侧核ADC明显低于对照组1(P<0.05);中度组2、重度组2放射冠ADC明显低于对照组2、轻度组2(P<0.05);中度组2、重度组2内囊后肢ADC明显低于对照组2(P<0.05),且重度组2明显低于轻度组2(P<0.05)。结论常规MRI联合DWI评估足月HIE严重程度具有较高应用价值。

Objective To observe the application value of routine magnetic resonance imaging(MRI)combined with diffusion-weighted imaging(DWI)in evaluating the severity of full-term hypoxic-ischemic encephalopathy(HIE).Methods A retrospective analysis was performed on 96 full-term HIE neonates in the hospital.According to disease severity,the patients with day age less than 7 d or within 7 to 28 d were divided into mild,moderate and severe groups.Fifty full-term neonates(no asphyxia history)during the same period were included in the control group.All patients underwent routine MRI and DWI.The region of interest(ROI)and apparent diffusion coefficient(ADC)in neonates with dayage less than 7 d and within 7 to 28 d were compared between different disease severity groups and corresponding day-age control group.Results The ADC of parietal white matter and frontal white matter in mild group 1,moderate group 1 and severe group 1 were significantly lower than that in control group 1(P<0.05).The corona radiata ADC in moderate group 1 and severe group 1 was significantly lower than that in mild group 1 and control group 1(P<0.05).The ADC of lateral ventricle white matter and posterior limb of the internal capsule in severe group 1 was significantly lower than that in the other three groups(P<0.05).The ADC of the posterior limb of internal capsule in moderate group 1 was significantly lower than that in control group 1(P<0.05).The ADC of the ventrolateral nucleus of the thalamus in severe group 1 was significantly lower than that in control group 1(P<0.05).The corona radiata ADC in moderate group 2 and severe group 2 was significantly lower than that in control group 2 and mild group 2(P<0.05).The ADC of the posterior limb of the internal capsule in moderate group 2 and severe group 2 was significantly lower than that in control group 2(P<0.05),and the above index in severe group 2 was significantly lower than that in mild group 2(P<0.05).Conclusion Routine MRI combined with DWI is of relatively higher application value in evaluating fullterm HIE severity.