摘要
目的 探讨足月新生儿窒息后脑损伤的MRI表现及DWI技术的诊断价值。方法 搜集71例临床有明确窒息史的足月新生儿进行MRI检查,运用GEAW 4.3工作站,由两位不知道临床表现的影像科医生采用双盲法回顾性分析71例患儿的MRI图像结果 。结果 1DWI与常规T1WI的比较,本组病例资料中,轻度窒息在DWI上的异常所见多为位于沿侧脑室壁、侧脑室三角部的室管膜下的小斑点状、条状高信号,其次是皮层及其皮层下白质片状高信号,中重度窒息DWI上早期特征性改变为内囊后肢呈现明显高信。2检查时间3 d内的患儿,四种序列的敏感性依次为DWI〉T1WI〉FLAIR〉T2WI;检查时间生后4-7 d的患儿四种序列的敏感性依次为T1WI〉DWI〉FLAIR〉T2WI。结论 1足月儿缺氧缺血后脑损伤好发于矢状旁区。2DWI显示脑内非出血性病灶的敏感性高,尤其是对缺氧缺血性病灶的显示早期（〈3 d）明显比MRI常规扫描具有更高的敏感性,有助于对有窒息史的患儿进行早期干预,对治疗及预后有很大帮助。
Objective To discuss the MRI features and the diagnostic value of diffusion weighted imaging（DWI）of brain damage in full-term newborns with asphyxia.Methods 71 full-term newborns with clinically definite asphyxia history were selected and tested with MRI.By using GEAW 4.3 workstation, two doctors from the Radiology Section who did not know the clinical manifestation retrospectively analyzed the MR/ image results of the 71 infants with double-blind method.Results （1）From the comparison of DWl and conventional T1WI on the data of this group of patients ,the abnormal findings of mild asphyxia on DWI were mostly located on the ependymal small spots and strip-shaped intensified signals along the lateral ventricle wall and the trigone of lateral ventricle, followed by the intensified signals in the cortex and the flake-shaped white matter under the cortex.The early stage characteristic changes of moderate and severe asphyxia on DWI were shown by the clear intensified signals on the posterior limb of internal capsule. （2） The examination of newborns within 3 days showed the sensitivity of the four series was DWI 〉 T1WI 〉 FLAIR 〉 T2WI ; The examination of newborns within 4 - 7 days showed the sensitivity of the four series was T1WI 〉 DWI 〉 FLAIR 〉 T2WI.Conclusion （1）Hypoxic ischemic brain damage in full-term newborns often occurs in the parasagittal area. （2）DWI shows that the non-hemorrhagic brain damage has high sensitivity, particularly the early display of hypoxic-isehemic damage（ 〈 3 days） had significantly higher sensitivity than MRI normal scan, so DWI is helpful for the early intervention on the newborns with asphyxia history and also has great help for treatment and prognosis.
出处
《中国疗养医学》
2015年第12期1271-1274,共4页
Chinese Journal of Convalescent Medicine
关键词
MR
DWI
足月儿
窒息
Magnetic resonance （MR）
Diffusion weighted imaging（DWI）
Full-term newborns
Asphyxia
