MRI-DTI对缺氧缺血性脑病的诊断价值及影像学特征分析

Value of MRI-DTI in diagnosis of hypoxic-ischemic encephalopathy and its imaging characteristics

目的探究磁共振-弥散张量成像(MRI-DTI)对缺氧缺血性脑病(HIE)的诊断价值,并分析其影像学特征。方法抽取2020年7月至2021年7月郑州市第三人民医院收治的62例成年HIE患者(HIE组)以及同期医院收治的41例非HIE患者(非HIE组)为研究对象。两组患者均行MRI-DTI检查获得感兴趣区各向异性指数(FA)、表观扩散系数(ADC)以及平均弥散系数(MD)等DTI参数。HIE组患者依据病情严重程度分为轻度HIE患者与中重度HIE患者。分析非HIE与HIE患者的影像学表现;比较非HIE与HIE患者DTI参数差异,分析DTI参数与患者病情严重程度的相关性及其对患者病情的诊断价值。结果非HIE患者MRI检查可见脑白质T1信号略高于灰质,T2高信号白质略低于灰质,脑脊液呈T1低信号、T2高信号,脑白质纤维束正常;HIE患者MRI检查可见明显条片状及斑点状短T1信号及混杂T2信号,DTI图可见病灶附近纤维束受压甚至断裂。HIE患者FA、ADC及MD值均低于非HIE组(P均<0.05),轻度HIE患者FA、ADC及MD值均高于中重度HIE患者(P均<0.05)。Spearman相关性分析结果显示,FA、ADC及MD与HIE患者病情严重程度呈负相关(r=-0.613、-0.543、-0.665,P均<0.05)。受试者工作特征曲线结果显示,FA、ADC、MD以及三指标联合用于预测HIE诊断的曲线下面积分别为0.777、0.906、0.873、0.969。结论MRI-DTI可清楚显示HIE患者脑组织损伤,其测定DTI参数与患者病情发生以及病情严重程度关系密切。

Objective To investigate the value of magnetic resonance imaging-diffusion tensor imaging(MRI-DTI)in the diagnosis of hypoxic-ischemic encephalopathy(HIE),and analyze its imaging characteristics.Methods Sixty-two adult patients with HIE(HIE group)and 41 patients without HIE(non-HIE group)admitted to Zhengzhou Third People’s Hospital from July 2020 to July 2021 were selected as the research subjects.All of them were subjected to MRI-DTI to obtain DTI parameters such as fractional anisotropy(FA)of region of interest,apparent diffusion coefficient(ADC),and mean diffusion coefficient(MD).Patients in the HIE group were divided into mild patients and moderate to severe patients according to the severity.Imaging findings of non-HIE group and HIE group were analyzed,and DTI parameters were compared between the two groups.The correlation of DTI parameters with severity of the disease,and diagnostic value of these parameters were analyzed.Results The non-HIE group showed slightly higher T1 and lower T2 signals of white matter than gray matter,low T1 and high T2 signal of cerebrospinal fluid,and normal white matter fiber bundles.The HIE group showed obvious strip and spotted short T1 signals,and mixed T2 signal;the fiber bundles near the lesion were compressed or even broken on DTI image.The FA,ADC and MD values of HIE group were significantly lower than those of the non-HIE group(all P<0.05).The FA,ADC and MD values of mild patients were significantly higher than those of the moderate to severe patients in HIE group(all P<0.05).Spearman correlation analysis showed that FA,ADC and MD were negatively correlated with the severity of HIE(r=-0.613,-0.543,-0.665;all P<0.05).The receiver operating characteristic curve showed that the area under curve values of FA,ADC,MD alone and combination of the three indexes to diagnose HIE were 0.777,0.906,0.873 and 0.969,respectively.Conclusions MRI-DTI can clearly show brain tissue damage in patients with HIE.DTI parameters are closely related to the occurrence and severity of HIE.