摘要
目的:探讨DWI在早产儿脑微小出血灶中的临床诊断价值,为早产儿脑微小出血灶的早期诊断和治疗提供理论基础,以改善该类患儿的预后。方法:选取2018年5月至2019年11月我院收治的78例早产合并脑出血患儿,分别行T1WI、T2WI、FLAIR、DWI周围扫描,记录不同序列下患儿的脑出血灶个数以及兴趣区的ADC值,进行对比分析。结果:T1WI序列发现出血灶424个,T2WI序列发现出血灶274个,FLAIR序列发现出血灶441个,DWI序列发现出血灶459个。微小出血灶的ADC图中测量SD值显著低于正常。78例患儿中,有21例出现胼胝体压部DWI明显受限,ADC值降低,但常规MRI序列并未发现异常者。为进一步探寻诊断的最佳时机,根据患儿出生后纳入研究时间将其分为A组(≤7天)和B组(8~28天)。A组患儿的出血ADC值、胼胝体压部ADC值和丘脑ADC值均低于B组患儿,差异有统计学意义(P<0.05)。结论:应用DWI为早产儿脑微小出血灶的早期诊断提供了有力依据,结合表面弥散系数(ADC)能够对丘脑腹核、胼胝体压部等特殊敏感部位的早期脑组织损伤进行评估,进而进行针对性的治疗策略,具有一定临床价值。
Objective:To explore the clinical diagnostic value of DWIon cerebral microhemorrhage in premature infants,and to provide theoretical basis for early diagnosis and treatment of cerebral microhemorrhage in premature infants,so as to improve the prognosis of them.Methods:78 premature infants complicated with cerebral hemorrhage treated in our hospital from May 2018 to November 2019 were selected,andperipheralscans of T1 WI,T2 WI,FLAIR and DWI were performed respectively.The number of cerebral hemorrhage foci and ADC values of regions of interest in different sequences were recorded and compared.Results:424 hemorrhage foci were found in T1 WI sequence,274 hemorrhage foci were found in T2 WI sequence,441 hemorrhage foci were found in FLAIR sequence,and 459 microhemorrhage foci were found in DWI sequence.The SD value measured in the ADC map of microhemorrhage foci was significantly lower than normal value.Among the 78 cases,21 cases showed obvious limitation of DWI and decrease of ADC value in the splenium of corpus callosum,but no abnormality was found in routine MRI sequence.In order to further explore the best time for diagnosis,the children were divided into group A(≤7 days)and group B(8~28 days)according to the time of inclusion in the study after birth.The ADC values of hemorrhage,corpus callosum and thalamus in group A were lower than those in group B,the difference was statistically significant(P<0.05).Conclusion:The application of DWI provides a powerful basis for the early diagnosis of microhemorrhage in premature infants.Combined with apparent diffusion coefficient(ADC),it can evaluate the early brain injury in special sensitive areas such as ventral nucleus of thalamus and splenium of corpus callosum,so as to carry out targeted treatment strategies,which has certain clinical value.
作者
陈巍岚
郭作梁
陈宁
Chen Weilan;Guo Zuoliang;Chen Ning(Department of Radiology,Chaonan Minsheng Hospital of Shantou City Shantou,Guangdong 515100)
出处
《现代医用影像学》
2020年第4期606-609,共4页
Modern Medical Imageology
关键词
早产儿
脑出血
表面弥散系数
Premature infants
Cerebral hemorrhage
Apparent diffusion coefficient(ADC)
