磁共振和CT在新生儿缺氧缺血性脑病的诊断及预后评估中的价值对比

Comparison of the value of magnetic resonance imaging and CT in the diagnosis and prognostic evaluation of neonatal hypoxic ischemic encephalopathy

目的分析对比磁共振和CT在新生儿缺氧缺血性脑病(HIE)诊断及预后评估中的价值,为临床应用提供依据。方法回顾性分析2019年9月~2020年1月于井冈山大学附属医院接受诊治的80例HIE新生儿,所有患儿均符合《新生儿缺氧缺血性脑病诊断标准》中的相关标准确诊,均接受磁共振成像检查与CT检查。以临床诊断结果为“金标准”,对比两种检查方式对新生儿HIE的检出率与诊断病情分度的准确度及对颅内出血的检出率。结果磁共振对新生儿HIE的检出率与诊断病情分度的准确度均高于CT,差异有统计学意义(P<0.05);CT对蛛网膜下腔出血的检出率高于磁共振,而磁共振对基底节区出血的检出率高于CT,差异有统计学意义(P<0.05)。结论磁共振和CT均可用于新生儿HIE的诊断,其中磁共振的诊断及预后评估价值高于CT,且磁共振更易发现基底节区出血,而CT更易发现蛛网膜下腔出血。

Objective To analyze and compare the value of magnetic resonance imaging and CT in the diagnosis and prognostic evaluation of neonatal hypoxic ischemic encephalopathy(HIE),and to provide a basis for clinical application.Methods A total of 80 cases of neonatal HIE who were treated in Affiliated Hospital of Jinggangshan University from September 2019 to January 2020 were retrospectively analyzed.All children were diagnosed according to the relevant criteria in the Diagnostic Criteria for Neonatal Hypoxic Ischemic Encephalopathy,and all of them underwent magnetic resonance imaging and CT examinations.The clinical diagnosis result were taken as the gold standard,the detection rate of neonatal HIE,diagnostic coincidence rate of the severity of disease and the detection rate of intracranial hemorrhage of two detection methods were compared.Results The detection rate of neonatal HIE and the diagnostic coincidence rate of the severity of disease of magnetic resonance imaging were higher than those of CT,the differences were statistically significant(P<0.05).The detection rate of subarachnoid hemorrhage of CT was higher than that of magnetic resonance imaging,while the detection rate of basal ganglion hemorrhage of magnetic resonance imaging was higher than that of CT,the differences were statistically significant(P<0.05).Conclusion Magnetic resonance imaging and CT can be used for the diagnosis of neonatal HIE.Among them,the diagnostic and prognostic value of magnetic resonance imaging is higher than that of CT,magnetic resonance imaging is easier to detect basal ganglion hemorrhage,and CT is more likely to detect subarachnoid hemorrhage.