不同MRI技术在诊断新生儿HIE中的应用研究

Application of different MRI techniques in the diagnosis of neonatal HIE

目的:分析不同MRI技术在诊断新生儿缺氧缺血性脑病(HIE)中的应用价值。方法:回顾性分析2015年7月~2017年2月我院收治的46例HIE患儿的临床资料,所有患儿入院后均完成常规MRI扫描、磁敏感加权成像(SWI)及弥散加权成像(DWI)扫描,分析不同MRI技术诊断新生儿HIE的临床价值。结果:(1)本组46例HIE患儿共检出病灶130枚,其中SWI扫描检出病灶数目最多(86.92%),其次为DWI序列(70.00%),常规MRI序列中以T2 FLAIR序列检出病灶数目最多(56.92%),HIE患儿病灶主要分布于大脑皮质区,其次为室鼓膜,DWI对大脑皮质损伤诊断阳性率高,SWI对小脑、鼓室膜、硬膜下与硬膜外损伤诊断阳性率较高。(2)46例HIE常规MRI检出阳性21例,DWI检出27例,SWI检出33例,DWI+SWI联合检出41例,以三者联合检查检出HIE阳性率最高(89.13%),其次为SWI序列(71.74%)。结论:MRI不同序列中以SWI对新生儿HIE诊断阳性率最高,其次为DWI序列,采用DWI联合SWI序列扫查可提高HIE早期检出率。

Objective To analyze the application value of different MRI techniques in the diagnosis of neonatal hypoxic ischemic encephalopathy(HIE). Methods The clinical data of 46 cases of children with HIE treated in our hospital from July 2015 to July 2017 were retrospectively analyzed. All children were examined routine MRI scan, magnetic susceptibility weighted imaging(SWI) and diffusion weighted imaging(DWI) scan. The clinical value of different MRI techniques in the diagnosis of neonatal HIE was analyzed. Results(1)There were a total of 130 lesions detected in 46 cases of children with HIE, and the number of lesions detected by SWI scanning was the largest(86.92%), followed by DWI sequence(70.00%). Among conventional MRI sequences, the number of lesions detected by T2 FLAIR was the largest(56.92%). Most lesions were distributed in the cerebral cortex, then ventricular tympanic membrane. The positive rate of DWI in the diagnosis of cerebral cortex injury was high while the positive rates of SWI in the diagnosis of cerebellum, tympanic membrane, subdural and epidural injury were high.(2)There were 21 positive cases detected by conventional MRI, 27 cases detected by DWI, 33 cases by SWI and 41 cases by DWI+SWI combined detection. The positive rate of combined detection of the above three for HIE was the highest(89.13%), followed by SWI sequence(71.74%). Conclusion The positive rate of SWI in MRI sequences is the highest in the diagnosis of neonatal HIE, followed by DWI sequence. The combination of DWI and SWI sequence scanning can improve the detection rate of early HIE.