DWI在新生儿脑实质及脑室系统微出血检出中的临床应用

Clinical Application of DWI in Detection of Microbleeds in Neonatal Brain Parenchyma and Ventricle System

目的观察扩散加权成像(DWI)在新生儿脑实质及脑室系统微出血检出中的应用。方法选择2017年1月至2022年4月期间于清华大学第一附属医院放射科行头颅MR检查SWI确诊发生脑实质微出血(CMBs)和/或脑室系统微出血(CVMBs)的新生儿作为研究对象,共134例,记录、比较各个序列(T_(1)WI、T_(2)WI和DWI、SWI)在CMBs和CVMBs两方面检出微出血灶数目的差异。结果CMBs方面T_(1)WI、T_(2)WI、DWI、SWI检测出微出血灶数目分别为30、55、110、163,检出数整体比较存在统计学差异(P<0.05),其中DWI和T_(1)WI、T_(2)WI比较有统计学差异(χ^(2)=6.605、5.501,均P<0.0083,Bonferroni校正),DWI和SWI比较无统计学差异(χ^(2)=1.917,P=0.331>0.0083,Bon ferroni校正);CVMBs方面T_(1)WI、T_(2)WI、DWI、SWI检测出微出血灶数目分别为34、118、111、139,检出数整体比较存在统计学差异(P<0.05),其中DWI和T_(1)WI比较有统计学差异(χ^(2)=5.566,P<0.0083,Bonferroni校正),DWI和T_(2)WI、SWI比较无统计学差异(χ^(2)=0.601、2.308,均P>0.0083,Bonferroni校正)。结论DWI比常规序列在新生儿微出血灶的检出方面具有一定优势,有较高的临床应用价值。

Objective To explore the clinical application of diffusion weighted imaging(DWI)in the detection of microbleeds in neonatal brain parenchyma and ventricular system compared with susceptibility weighted imaging(SWI).Methods The imaging data of 134 neonates with cerebral microbleeds(CMBs)and/or cerebral ventricular microbleeds(CVMBs)diagnosed by SWI were retrospectively analyzed.The differences of the number of microbleeds detected by each sequence(T_(1)WI,T_(2)WI and DWI,SWI)in CMBs and CVMBs were recorded and compared.Results In terms of CMBs,the number of microbleeds detected by T_(1)WI,T_(2)WI,DWI and SWI was 30,55,110 and 163,respectively,and there was a statistically significant difference in the overall number of comparison(P<0.05);there were significant differences between DWI and T_(1)WI,and between DWI and T_(2)WI(P<0.0083,Bonferroni correction),however,there was no significant difference between DWI and SWI(P>0.0083,Bonferroni correction).In terms of CVMBs,the number of microbleeds detected by T_(1)WI,T_(2)WI,DWI and SWI were 34,118,111 and 139 respectively.There was a significant difference in the overall detection number(P<0.05);there was a significant difference between DWI and T_(1)WI(P<0.0083,Bonferroni correction),and there was no significant difference between DWI and T_(2)WI,and between DWI and SWI(P>0.0083,Bonferroni correction).Conclusion DWI can complete the detection of microbleeds by means of magnetic susceptibility artifacts,especially in CMBs,which is better than the conventional sequence to some extent,and has high clinical application value.