SWI相位图定量分析在新生儿缺氧缺血性脑病中的诊断研究

Study on Quantitative Analysis of Phase Map of Magnetic Sensitivity Weighted Imaging in Diagnosis of Neonatal Hypoxic Ischemic Encephalopathy

目的:探讨磁敏感加权成像(SWI)相位图定量研究新生儿缺氧缺血性脑病(HIE)价值,以及在HIE和非HIE的窒息患者中的鉴别诊断作用。方法:收集37例HIE患儿(HIE组),24例非HIE患儿(非HIE组)及42名正常足月新生儿(对照组)行高分辨率SWI序列检查,将SWI相位图线性配准到新生儿脑图谱标准空间,通过ANOVA方差分析对三组间的脑区体素均值进行差异性分析,然后重点观察HIE组和非HIE组二者间的差异。利用机器学习算法以及ROC曲线分析推断HIE组和非HIE组间单个差异脑区及全差异脑区在2组鉴别诊断中的价值。结果:共有6个脑区在三组间具有显著差异,与非HIE组的窒息患儿相比,HIE组患儿内囊前肢及尾状核SWI相位位移值减低。ROC曲线分析显示,内囊前肢及全差异脑区在HIE组和非HIE组的窒息患儿鉴别诊断中具有中等程度敏感度和特异度,其曲线下面积分别为0.75和0.76。结论:SWI相位图可用于定量观察HIE患者局部脑组织缺氧状态,HIE的早期诊断有很高的应用潜力。

Objective:To explore the value of SWI phase image in quantitative study of neonatal hypoxic ischemic encephalopathy(HIE)and its differential diagnosis in asphyxia patients with HIE and non-HIE.Methods:37 cases of HIE(HIE group),24 cases of non-HIE(non-HIE group)and 44 cases of normal full-term newborns(control group)were examined by high-resolution SWI sequence.The SWI phase map was linearly registered to the self-T2WI structure image,and the voxel mean value of each brain region was extracted after the linear and non-linear transformations.The dfference of voxel mean value among the three groups was analyzed using the ANOVA analysis,and then the dfference between HIE group and non-HIE group was further evaluated.ROC curve analysis was used to infer the value of differential brain regions and whole differential brain regions between HIE group and non-HIE group in differential diagnosis between the two groups.Results:There were significant differences in 6 brain regions among the three groups.Compared with the asphyxiated children without HIE,the SWI phase displacement of the anterior limb of the internal capsule and the caudate nucleus in the HIE group was lower than that in the non-HIE group.ROC curve analysis showed that the anterior limb of the internal capsule and the whole differential brain regions had moderate sensitivity and specificity in the differential diagnosis of asphyxia between the HIE group and the non-HIE group,and the area under the curve was 0.75 and O.79,respectively.Conclusion:SWI phase image can be used to quantitatively observe the hypoxia status of local brain tissues in HIE patients,and has the potential to be applied in the early diagnosis of HIE.