脑电图联合MRI在新生儿缺氧缺血性脑病诊断及预后的应用

Application of electroencephalography combined with MRI in the diagnosis and prognosis of neonatal hypoxic-ischemic encephalopathy

目的:分析脑电图(EEG)联合MRI在新生儿缺氧缺血性脑病诊断及预后的应用价值。方法:缺血缺氧性脑病足月患儿和健康足月新生儿各42例,按照是否确诊缺血缺氧性脑病分为观察组和对照组。对两组新生儿进行脑部MRI动脉自旋标记扫描和振幅整合EEG(aEEG)检查,随访6个月,记录并发症和生存情况。结果:(1)观察组患儿aEEG异常比例显著高于对照组(P<0.05);(2)观察组患儿基底节区和丘脑呈高灌注状态,额叶呈低灌注状态;(3)正常aEEG新生儿中,观察组患儿丘脑核基底节区灌注均值显著高于对照组;(4)aEEG正常和中度异常新生儿中,不良预后患儿丘脑和基底节区灌注显著高于预后良好患儿。结论:EEG联合头颅MRI能够显著提高新生儿缺氧缺血性脑病诊断的敏感性,对不良预后有一定的预测价值。

Objective To analyze the application value of electroencephalography(EEG)combined with magnetic resonance imaging(MRI)in the diagnosis and prognosis of neonatal hypoxic-ischemic disease.Methods Forty-two neonates with neonatal hypoxic-ischemic encephalopathy and 42 healthy neonates were divided into observation group and control group according to whether or not hypoxic-ischemic encephalopathy was diagnosed.Two groups of neonates underwent cerebral MRI arterial spin labeling scans and amplitude-integrated EEG(aEEG)examinations,and they were followed-up for 6 months.The complications and survival in the neonates were recorded.Results(1)The proportion of neonates with abnormal aEEG in observation group was significantly higher than that in control group(P<0.05).(2)Neonates in observation group showed hyperperfusion in the basal ganglia and the thalamus,but hypoperfusion in the frontal lobe.(3)Among neonates with normal aEEG,those in observation group had significantly higher mean values of perfusion in the basal ganglia of thalamic nuclei than those in control group.(4)Among neonates with normal and moderately abnormal aEEG,those with poor prognosis has obviously higher perfusion in the thalamus and the basal ganglia than those with favorable prognosis.Conclusion EEG combined with cerebral MRI in neonatal hypoxic-ischemic encephalopathy can significantly improve the sensitivity of diagnosis and has predictive value for poor prognosis.