新生儿缺氧缺血性脑病的MR诊断及临床相关因素分析

MRI diagnosis of neonatal hypoxic-ischemic encephalopathy and analysis of clinical correlative factors

目的 :探讨磁共振成像对新生儿缺氧缺血性脑病 (hypoxicischemicencephalopathy ,HIE)的诊断价值及临床的相关性。方法 :搜集 62例临床诊断为HIE的患儿 ,对其进行常规MRI的T1WI、T2 WI及FLAIR序列检查。结果 :HIE患儿MRI的T1WI及FLAIR序列病灶检出率明显高于T2 WI(P <0 .0 5 ) ;早产儿病变区域多位于脑室旁、室管膜下及基底节区 ;足月儿病变区域多位于大脑皮质及颞顶部 ;新生儿HIE早期Apgar评分与MRI脑白质损伤影像分级及远期后遗有一定相关性 ,非绝对相关 ,而另与胎龄有关。结论 :MRI对HIE的诊断有高度的敏感性 ;不同胎龄HIE患儿脑损伤区域不同 。

Objective:To study the role of MR imaging in diagnosing neonatal hypoxic ischemic encephalopathy(HIE) and the correlation with clinic.Methods:Sixty two cases of asphyxial perinatal neonates,who were diagnosed HIE by clinic and performed MR imaging,were collected.Results: T 1 weighted images and T 2 weighted images with fluid attenuated inversion recovery (FLAIR) sequence were significantly superior in T 2 weighted images with SE sequence in the detection of HIE ( P <0.05).HIE was mostly located in periventricular white matter,subependymal,basal ganglia areas in prematures.In full term neonate,however,HIE mostly lay in cerebral cortex and temporal and parietal lobe.There was a partial correlation between Apgar scores and grading of brain damage on MR images in early HIE and sequela,but not completely correlative each other.And it is also correlative with ages.Conclusion:MR imaging is highly sensitive in detecting early HIE.There are different MRI findings with different ages,and so is the different sequela with different regions of the lesion.