摘要
目的探讨磁敏感加权成像(suscepeibility weighted imaging SWI,GE称为ESWAN)结合扩散张量成像(diffusion tensor imaging,DTI)FA值对新生儿缺氧缺血性脑病(hypoxie-ischemic encephalopathy,HIE)的诊断价值。方法对30例确诊为HIE的足月新生儿行常规MRI序列(包括T1WI、T2WI、T2Flair)、ESWAN、DTI检查,同时选择同期18例正常足月新生儿作为对照组。分别统计病例组常规MRI及ESWAN各序列对颅内出血灶的检出个数,比较检出率有无差异;进一步测量两组新生儿放射冠区脑白质、内囊前肢、后肢、胼胝膝部、压部及豆状核FA值,并进行组间比较。结果ESWAN对颅内出血检出率明显高于常规序列。病例组与对照组放射冠区脑白质、胼胝体膝部、压部、内囊前肢、后肢的FA值差异有统计学意义(P<0.05),豆状核组间差异无统计学意义(P>0.05)。结论 ESWAN在检出HIE患儿颅内出血灶方面较常规序列敏感且准确,同时,DTI在检测脑白质损伤方面具有较高的敏感性,并且能通过FA值定量测量对其量化,两者结合是对常规MRI检查的有力补充,可提高HIE诊断能力,对临床早期确诊HIE并制定合理的治疗方案具有积极意义。
[Abstract] Objective To evaluate the application value of susceptibility weighted imaging （ESWAN） in combination with diffusion tensor imaging （DTI） at early detection of brain injury caused by hypoxic-isehemic encephalopathy （HIE） in term neonates. Methods Conventional magnetic resonance image （MRI）, ESWAN and DTI were performed in 30 neo- nates, who presented with asphyxy and were clinically diagnosed with HIE. Eighteen full-term neonates without HIE were severed as a control group. The numbers of intracranial hemorrhagic focus were detected by MRI and ESWAN respectively and the detection rates were statistically analyzed. Then, the fractional anisotropy （FA） was measured bilaterally in corona radiata, anterior limb of internal capsule, posterior limb of internal capsule, corpus callosum, and entiformin necleus, and compared between these two groups. Results The detection rate of ESWAN was significantly higher than that of conven- tional MRI. The differences of FA value in corona radiata, anterior limb of internal capsule, posterior limb of internal cap- sule, and corpus callosum between HIE group and control subjects were statistically significant （ P 〈0.05）. No signifi- cant difference of FA value in lentiform nucleus was found in this work （ P 〉0.05）. Conclusion ESWAN has the ex- tremely high sensitivity and accuracy in detection of newborn hemorrhagic focus. DTI has high sensitivity in detecting white matter damage. Quantitative diffusion anisotropy imaging can improve conspicuity white matter damage. ESWAN combined with FA value is a powerful complement to conventional MRI, which has positive significance for early clinical diagnosis of HIE and formulates reasonable treatment scheme.
出处
《医学影像学杂志》
2013年第8期1165-1169,共5页
Journal of Medical Imaging
基金
陕西省科学技术研究发展计划项目(编号:2010k150604)
关键词
新生儿缺氧缺血性脑病
磁共振成像
Hypoxie-ischemic encephalopathy
Magnetic resonance image
