摘要
目的探讨扩散张量成像(DTI)结合磁敏感加权成像(SWI)对新生儿缺氧缺血性脑病(HIE)的诊断价值。方法随机选取赤峰市医院自2015年6月至2017年6月诊断为HIE的新生儿76例为观察组,健康足月新生儿40例为对照组,采用MR扫描仪,行常规头部MRI(包括T1WI、T2WI、T2Flair)及横轴位SWI、DTI检测,比较常规MRI与SWI联合DTI的检出率的差异;比较常规MRI及SWI对颅内出血病灶的检出个数,比较检出率的差异;比较两组新生儿放射冠区脑白质、内囊前肢、后肢、胼胝压部、膝部及豆状核的FA值。结果在76例患儿中,共检测出69例阳性患儿,SWI联合DTI的检出率明显高于常规MRI(90.8%比60.5%,P<0.01);SWI对颅内出血的检出率明显高于常规MRI序列(P<0.05);观察组放射冠区脑白质、胼胝体膝部、压部、内囊前肢、后肢的FA值明显低于对照组(P<0.05);两组豆状核FA值比较,差异无统计学意义(P>0.05)。结论 DTI联合SWI可以明显提高HIE的检出率,DTI在检测脑水肿及脑白质损伤方面有更高的诊断价值,SWI在检测颅内出血的部位和类型方面敏感性更高,两者结合应用是对常规MRI检查进一步完善,可以更及时的诊断和治疗HIE。
Objective To investigate the diagnostic value of diffusion tensor imaging（ DTI） combined with magnetic susceptibility weighted imaging（ SWI） for neonatal hypoxic-ischemic encephalopathy（ HIE）. Methods A retrospective study was performed on76 neonates diagnosed as HIE from June 2015 to June 2017. HIE neonates were divided into the observation group,the other healthy full-term neonates were in the normal group. Conventional MRI was performed（ including T1 WI,T2 WI and T2 Flair） and horizontal axial SWI and DTI detection. The difference of detection rate between conventional MRI and SWI combined with DTI was compared. The number of detected lesions and detected rates of intracranial hemorrhage by conventional MRI and SWI was compared. The FA values of the neonatal cortical white matter,the forelimb of the internal capsule,the hindlimb,the mandibular pressure,the knee and the lenticular nucleus were compared. Results Among the 76 cases of HIE neonates,69 cases of positive HIE were detected. The detection rate of SWI combined with DTI was significantly higher than that of conventional MRI（ 90. 8% versus 60. 5%,P〈 0. 01）. SWI has a significantly higher detection rate than conventional MRI sequences for intracranial hemorrhage（ P〈 0. 05）. The FA values of the cortical white matter,corpus callosum,compression part,internal capsule forelimb and hind limb in the observation group were significantly lower than those in the normal group（ P〈 0. 05）. There was no statistically significant difference in the FA value of the lenticular nucleus between the two groups（ P〉 0. 05）. Conclusion DTI combined with SWI can significantly increase the detection rate of HIE.DTI has higher diagnostic value in detecting brain edema and white matter damage. SWI has higher sensitivity in detecting the location and type of intracranial hemorrhage. The combined application of the two methods can improve the routine MRI examination,and to timely perform the diagnosis and treatment of HIE.
作者
张志达
丛刊
谭淑睿
吕兴隆
ZHANG Zhi-da;CONG Kan;TAN Shu-rui;LYU Xing-long(Department of MR Room, Chifeng Municipal Hospital, Chifeng 024000, Chin)
出处
《临床军医杂志》
CAS
2018年第6期628-630,633,共4页
Clinical Journal of Medical Officers
基金
赤峰市医院科研计划项目
关键词
扩散张量成像
磁敏感加权成像
新生儿缺氧缺血性脑病
诊断价值
Diffusion tensor imaging
Magnetic susceptibility weighted imaging
Neonatal hypoxic-ischemic encephalopathy
Diagnostic value
