MRI监测早产儿与足月儿低血糖脑损伤

MRI monitoring of hypoglycemic brain injury in preterm and term infants

目的探讨早产儿与足月新生儿低血糖脑损伤在MRI监测下的影像表现与差异。方法采用MAGNETOM Avanto 1.5T磁共振扫描仪,行头颅平扫+DWI功能成像。结果177例MRI检查中早产儿低血糖脑部异常表现占60.3%(38/63),足月儿低血糖脑部异常表现占55.3%(63/114);发生在顶枕叶典型部位弥散受限分别为11例(17.5%)、25例(21.9%),伴随白质区T 2WIFlair明显低信号分别为5例(7.9%)、14例(12.3%),差异无统计学意义(P>0.05)。颅内出血发生率分别为22例(34.9%)、24例(21.1%),差异有统计学意义(P=0.044)。随访结果:语言运动发育落后11例,枕叶癫痫16例,视力损害6例,均为顶枕叶脑损伤患儿。结论严重新生儿低血糖致脑损伤后,将影响患儿神经运动等发育,甚至导致脑瘫、癫痫等严重并发症。MRI是监测低血糖脑损伤的重要方法之一,对早期发现、指导临床治疗及预后评估均有重要意义。

Objective To explore the imaging manifestations and differences of hypoglycemic brain injury in preterm and term infants under the monitoring of multimodal MRI.Methods Magnetom avanto 1.5 T MR scanner was used in MRI for head plain scan+DWI functional imaging.Results Among 177 cases of MRI examination,60.3%(38/63)of premature infants had abnormal brain manifestations of hypoglycemia,and 55.3%(63/114)of full-term infants had abnormal brain manifestations of hypoglycemia;In the typical parts of the parietooccipital lobe,diffusion limitation was 11(17.5%)and 25(21.9%)respectivelythe;The low signal of T 2WI flair in the white matter region was 5(7.9%),14(12.3%)respectively,The differences were not statistically significant(P>0.05).The incidence of intracranial hemorrhage was 22(34.9%)and 24(21.1%)respectively,and the difference was statistically significant(P=0.044).Conclusion Severe neonatal hypoglycemia induces brain injury that will affect children's neuromotor development,and even lead to cerebral palsy,epilepsy and other serious complications.MRI is one of the important methods to monitor hypoglycemic brain injury,which is of great significance for early detection,clinical treatment and prognosis evaluation.