MRI在早产儿缺血缺氧性脑损伤诊断及预后脑发育评估中的应用观察

Application of MRI in the Diagnosis of Hypoxic-ischemic Brain Damage and Prognosis Evaluation of Brain Development in Premature Infants

目的探讨MRI在早产儿缺血缺氧性脑损伤诊断及预后脑发育评估中的应用价值。方法选取2018年1月至2019年12月42例缺血缺氧性脑损伤早产儿设为病例组,选取同期住院的30例非脑病早产儿设为对照组,记录所有早产儿出生5min的Apgar评分,并于出生后7d进行MRI检查,计算T1加权成像(T1WI)、T2加权成像(T2WI)、弥散加权成像(DWI)的感兴趣区的信号强度值T1值、T2值、DWI值。病例组治疗后随访1年,于12月龄时复查MRI并接受贝利婴幼儿发展量表Ⅲ(BSID-Ⅲ)评估预后。结果病例组出生5min Apgar评分低于对照组(P<0.05),病例组出生7d内的MRI测量值T1值、T2值、DWI值均高于对照组(P<0.05)。病例组12个月龄的MRI测量值T1值、T2值、DWI值均低于出生7d的MRI测量值(P<0.05),病例组12个月龄的BSID评分高于出生7d的BSID评分(P<0.05)。出生7d的MRI测量值T1值、T2值、DWI值与出生5min Apgar评分无明显相关性(P>0.05),12个月龄的MRI测量值T1值、T2值、DWI值与12个月龄的BSID评分呈负相关(r=-3.554,r=-4.367,r=-4.228,P<0.001)。结论 MRI不仅可以早期诊断早产儿缺血缺氧性脑损伤,而且还能评估脑发育预后,临床应用价值高。

Objective To explore the application value of MRI in the diagnosis of hypoxic-ischemic brain damage and prognosis evaluation of brain development in preterm infants.Methods 42 preterm infants with hypoxic-ischemic brain damage treated between January 2018 and December 2019 were selected as the case group,and 30 preterm infants without encephalopathy hospitalized during the same period were selected as the control group.The Apgar scores of all subjects were recorded at 5 min after birth and MRI examination was performed at 7 days after birth.The signal intensity values in the region of interest T1 value,T2 value and DWI value of T1-weighted imaging(T1 WI),T2-weighted imaging(T2 WI)and diffusion weighted imaging(DWI) were calculated.The case group was followed up for 1 year after treatment.MRI reexamination was performed at 12 months old and the prognosis was assessed with the Bayley scales of infant development-Ⅲ(BSID-Ⅲ).Results The Apgar scores of the case group at5 min after birth were lower than those of the control group(P<0.05).The MRI measurement values T1 value,T2 value and DWI value of the case group within 7 days after birth were higher than those of the control group(P<0.05).However,the above values of the case group at 12 months old were all lower than those at 7 days after birth(P<0.05).The BSID scores of the case group at 12 months old were higher than those at 7 days after birth(P<0.05).There was no significant correlation between the MRI measurement values T1 value,T2 value,DWI value at 7 days after birth and the Apgar score at 5 minutes after birth(P>0.05).However,the above value were negatively correlated with the BSID score at 12 months old(r=-3.554,r=-4.367,r=-4.228,P<0.001).Conclusion MRI can be used to not only diagnose early hypoxic-ischemic brain damage in premature infants,but also evaluate the prognosis of brain development,with high clinical value.