摘要
目的探讨新生儿脑梗死的磁共振成像(magnetic resonance imaging,MRI)及磁共振血管成像(magnetic resonance angiography,MRA)特点,为早期诊断提供依据。方法回顾性分析中国医科大学附属盛京医院新生儿科2012年1月至2019年1月收治的经MRI确诊的脑梗死患儿临床资料和影像学资料。结果共纳入47例脑梗死患儿,在怀疑脑梗死后2.3 d(1~7 d)行MRI检查,19例在怀疑脑梗死后10~18 d再次进行MRI检查。47例患儿中,左侧脑梗死33例(70.2%),其中25例为左侧大脑中动脉梗塞(53.2%),右侧脑梗死11例(23.4%),双侧脑梗死3例(6.4%);首次MRI扫描时35例(74.5%)T1WI异常低信号改变,40例(85.1%)T2WI高信号改变,再次扫描时(10~18 d)均表现为T1WI低信号改变、T2WI高信号改变;所有患儿弥散加权成像均为高信号改变。32例患儿进行MRA检查,11例存在异常(34.4%),平均检测时间为怀疑脑梗死后2.9 d(2~4 d);21例未发现异常,平均检测时间为怀疑脑梗死后4.5 d(2~10 d),差异有统计学意义(P=0.013)。早产儿与足月儿受累动脉、MRA异常比例、大面积梗死比例比较,差异均无统计学意义(P>0.05)。MRA是否异常与性别、出生体重、急性期惊厥、梗死面积、受累动脉等因素均无关(P>0.05)。结论常规MRI序列可协助了解新生儿脑梗死病程,弥散加权成像有助于早期诊断及明确梗死范围。MRA检查发现异常率较低,这可能与MRA检查滞后、梗塞动脉早期自动清除有关。
Objective To study the characteristics of magnetic resonance imaging(MRI)and magnetic resonance angiography(MRA)of cerebral infarction in neonates for early diagnosis.Method From January 2012 to January 2019,the clinical and imaging data of children with cerebral infarction confirmed by MRI admitted to our hospital were retrospectively analyzed.Result A total of 47 children diagnosed with cerebral infarction were included.MRI was performed 2.3 days(1~7 days)after suspected cerebral infarction,and re-checked in 19 cases 10~18 days after initial suspected cerebral infarction.Among the 47 cases,33 patients(70.2%)had left cerebral infarction,including 25 left middle cerebral artery infarction(53.2%).11 patients(23.4%)had right cerebral infarction,and 3 patients(6.4%)had bilateral cerebral infarction.For the first MRI,35 patients(74.5%)had abnormal low signal on T1WI,and 40 patients(85.1%)had abnormal high signal on T2WI.For the re-check of MRI(10~18 d),all patients showed low signal on T1WI and high signal on T2WI.All patients had high signal on diffusion-weighted imaging(DWI).A total of 32 patients received MRA examination,11 patients(34.4%)had abnormal results 2.9 days(2~4 days)after suspected cerebral infarction and the rest 21 patients had normal results 4.5 days(2~10 days)after suspected cerebral infarction,which showed statistically significant differences(P=0.013).No differences existed between preterm and term infant on infarcted artery,MRA abnormalities,and infarcted areas.No correlation was found between MRA abnormalities and gender,birth weight,seizure,infarcted area,infarcted artery.Conclusion Conventional MRI sequence may help determining the course of neonatal cerebral infarction.DWI is beneficial for early diagnosis and determining infarcted area.Due to delayed MRA examination and the early self-clearing process of the infarcted artery,few abnormal MRA is found.
作者
付佳博
富建华
薛辛东
Fu Jiabo;Fu Jianhua;Xue Xindong(Department of Pediatrics,Shengjing Hospital of China Medical University,Shenyang 110004,China)
关键词
脑梗死
磁共振成像
磁共振血管成像
婴儿
新生
Cerebral infarction
Magnetic resonance imaging
Magnetic resonance angiography
Infant,newborn
