缺氧缺血性脑病脑损伤早期诊断及预后评估影像学研究进展

Advances in imaging studies on early diagnosis and prognostic evaluation of brain damage in hypoxic-ischemic encephalopathy

缺氧缺血性脑病(HIE)是脑血流和氧供应不足而引起的脑病,导致不良的神经发育后果,如脑瘫、智力低下和癫痫等。自亚低温治疗的出现和近十几年中的广泛应用以来,HIE存活率显著提高。然而,尽管亚低温治疗降低了HIE患儿的死亡率并改善了其长期神经发育后果,但重度HIE患儿致残率仍然很高。了解如何早期诊断新生儿缺氧缺血性脑病并及时进行干预具有相当重要的临床意义,也是国内外广泛关注的重点。新生儿脑损伤后往往缺乏特定的神经学症状和体征,而影像学检查可直观地观察新生儿脑组织结构和颅内病变,在HIE的诊断、鉴别诊断以及预后评估中发挥着越来越重要的作用。以下对各影像学检查技术在新生儿缺氧缺血性脑病中的研究进展进行阐述。

Hypoxic ischemic encephalopathy is an encephalopathy caused by insufficient cerebral blood flow and oxygen supply,leading to adverse neurodevelopmental consequences,such as cerebral palsy,mental retardation and epilepsy.Since the emergence of mild hypothermia treatment and its wide application in the past ten years,the survival rate of HIE has increased significantly.However,although mild hypothermia treatment reduces the mortality of children with HIE and improves their long-term neurodevelopmental consequences,the disability rate of children with severe HIE is still high.Knowing how to diagnose neonatal hypoxic-ischemic encephalopathy in an early stage and intervene in time is of great clinical significance,and it is also the focus of extensive attention at home and abroad.Newborns often lack specific neurological symptoms and signs after brain injury,and imaging examinations can visually observe the neonatal brain tissue structure and intracranial lesions,which play an increasingly important role in the diagnosis,differential diagnosis and prognostic evaluation of HIE.The following describes the research progress of various imaging examination techniques in neonatal hypoxic-ischemic encephalopathy.