摘要
目的探讨早产儿脑白质损伤的磁共振成像(MRI)表现与临床病理特征的关系。方法回顾分析2014年10月~2016年10月在本院出生的38例脑白质损伤早产儿的临床、病理及MRI表现等相关资料,判断脑白质损伤常规MRI及弥散加权成像(DWI)表现与临床病理的关系。结果早产儿中脑白质损伤患儿的临床表现无明显特异性,主要会出现肌张力低下、自发动作减少、心跳减慢、神志淡漠、喂养困难等症状;38例患儿中局灶性脑白质损伤29例,病灶主要分布半卵圆中心、脑室前后角及脑室旁,表现为点状、条状或簇状病灶,弥漫性脑白质损伤9例,弥漫性病灶主要分布于脑室旁。患儿早期(1周内)MRI表现为DWI增强、T1WI正常或稍有增强、T2WI正常或减弱;1~2周时MRI信号较早期略有减弱,T1WI信号较早期增强;3~5周时脑白质软化病灶DWI和T1WI表现为低信号,T2WI表现为高信号。结论早产儿脑白质损伤患儿的临床表现不具有特异性,常规MRI不易诊出早期脑白质损伤,但可作为后期脑白质软化的预测指标,DWI对早期损伤较为敏感。
Objective To investigate the relationship between magnetic resonance imaging （MRI） and clinical pathological features of white matter damage in premature infants. Methods The clinical data and MRI performance of 38 cases of premature infants with white matter damage in our hospital from October 2014 to October 2016 were retrospectively analyzed, and the relationship between the performance of MRI and diffusion weighted imaging （DWI） and pathological characteristics of white matter damage were analyzed. Results The clinical manifestations of cerebral white matter damage in preterm infants had no obvious specificity, such as hypotonia, decreased spontaneous action, slow heartbeat, apathy and feeding difficulties. Of the 38 cases, 29 cases were focal cerebral white matter lesions and the lesions were mainly distributed in the center of the half oval, the anteroposterior ventricle of the ventricle and the ventricle of the ventricle; 9 cases were diffuse white matter lesions and the lesions mainly distributed in the ventricle. In the early stage of the injury （1 weeks）, the imaging showed enhanced DWI, normal or slightly increased T1WI, normal or decreased T2W1; The MRI signal was slightly reduced and the T1WI signal was slightly enhancement at 1-2 weeks; The DWI and T1WI of leukoencephalomalacia lesions showed low signal, but T2WI showed high signal at 3-5 weeks. Conclusion The clinical manifestations of children with white matter damage in premature infants are not specific. The conventional MRI is not easy to diagnose early white matter damage, but it can be used as a predictor of late Leukoen- cephalomalacia, DWI is more sensitive to early damage.
出处
《中国医药导报》
CAS
2017年第4期86-89,共4页
China Medical Herald
基金
河北省秦皇岛市科学技术局项目(201602A054)
关键词
早产儿
脑白质损伤
磁共振成像
弥漫加权成像
病理特征
Premature infants
White matter damage
Magnetic resonance imaging
Diffusion-weighted imaging
Pathological features
