磁共振波谱成像在新生儿缺氧缺血性脑病评估中的应用

Application of Magnetic Resonance Spectroscopy in Assessment of Neonatal Hypoxic Ischemic Encephalopathy

目的研究磁共振成像(MRI)联合质子磁共振波谱成像(1H magnetic resonance spectroscopy,1HMRS)在新生儿缺氧缺血性脑病(hypoxic-ischemic encephalopathy,HIE)中的预后早期评估。方法回顾性选取2018年11月—2019年10月于我院出生的患有HIE的足月新生儿23例作为HIE组,按照其是否存在明确宫内窘迫史将其分为轻中度组11例和重度组12例;另选取健康足月新生儿10例作为对照组。两组患儿均行MRI及1HMRS检查。分别对比各组患儿扫描后的异常征象情况及1HMRS扫描中各代谢物水平的比较情况,并分析其相关性情况。结果对照组10例患儿均未出现异常征象,HIE组患儿共出现了6种异常征象,其中轻中度组各征象出现例数均少于重度组,差异具有统计学意义(P<0.05);观察IHMRS扫描结果,各组间GLx-α/Cr、Lac/Cr比值均差异具有统计学(P<0.05),且GLx-α/Cr、Lac/Cr比值同临床分度间存在正相关(P<0.01)。结论MRI联合1HMRS对HIE的各征象观察良好,并对HIE的早期评估具有较高价值。

Objective To study the early prognosis of HIE by MRI combined with 1HMRS.Methods Selected 23 cases of full-term neonates with HIE born from November 2018 to October 2019 as the HIE group,there were 12 cases in the severe group and 10 cases of healthy full-term neonates as the control group.Both groups of children underwent MRI and 1HMRS examinations.Compared the abnormal signs of the children in each group after scanning and the comparison of the levels of each metabolite in the 1HMRS scan.Results The number of signs in the mild group was less than that in the severe group,and the difference was statistically significant(P<0.05);Observing the results of IHMRS scans,the GLx-α/Cr,Lac/Cr ratios between the groups were statistically different(P<0.05),and the GLx-α/Cr,Lac/Cr ratios had significant positive differences with clinical scale correlation(P<0.01).Conclusion MRI combined with 1HMRS is high value for the early evaluation of HIE.