摘要
目的探讨磁共振（MRI）多序列联合检查对早产儿脑损伤早期诊断的临床意义。方法回顾性分析新生儿重症监护室收治的160例早产儿的头颅MRI影像表现。结果160例早产儿中，76例发生脑损伤，脑损伤发生率为47．5％。早产儿脑损伤以缺血性病灶多见，最常见的是脑白质损伤，尤其是脑室周围白质软化。缺血性脑损伤表现为半卵圆中心、侧脑室周围斑片状或大片状T1加权成像（T1WI）高信号、他加权成像（T2WI）低信号，弥散加权成像（DWI）序列呈明显高信号。脑室周围白质软化MRI表现为斑片状T1WI低信号、T2WI高信号，DWI序列呈低信号。出血性损伤以脑室周围一脑室内出血多见，出血灶因出血时期不同其信号表现亦不同，急性期MRI表现为T1WI等信号或稍低信号、T2WI高信号；亚急性早期呈T1wI高信号、T2WI稍低信号，亚急性晚期呈T1wI和T2WI高信号，在磁敏感加权成像（SWI）序列上呈明显低信号。DWI对缺血灶的检出率高于常规扫描，比常规MRI能更早地显示缺血性脑损伤（X2=23．78，P〈0．05）。SWI对出血灶的检出率高于常规扫描，比常规MRI能更早地显示出血性脑损伤（X2=27．02，P〈0．05）。结论MRI检查，尤其是多序列联合检查，可作为早产儿脑损伤的早期诊断提供准确的影像学依据。
Objective To discuss clinical significance on early diagnosis of brain injury in premature infants with multiple sequence joint inspection of magnetic resonance imaging （MRI）. Methods The brain MRI findings of 160 premature infants treated by Neonatal Intensive Care Unit were analyzed retrospectively. Results In 160 premature infants, brain injury occurred in 76 cases,the incidence of brain injury was 47.5%. Ischemic lesions were seen more in brain injury in premature infants, cerebral white matter injury was the most common, especially periventricular leukoma- lacia. Ischemic brain injury performed patchy or large sheet increased signal intensity on T1 - weighted images （T1WI）, decreased signal intensity on T2 -weighted images （T2WI） and obviously increased signal intensity on diffusion weigh- ted imaging （DWI） in half egg circle center and around the lateral ventricle. Periventricular leukomalacia performed patchy decreased signal intensity on T1WI, increased signal intensity on T2WI and decreased signal intensity on DWI. Periventricular- intraventricular hemorrhage was seen more in hemorrhagic lesions. Hemorrhage stove was performed different signal because of different bleeding time. MRI performance in acute phase was iso - signal or slightly decreased signal intensity on T1WI, increased signal intensity on T2WI, increased signal intensity on T1WI, slightly decreased sig- nal intensity on T2WI in early subacute, increased signal intensity on T1WI and T2WI in late subacute and obviously decreased signal intensity on magnetic sensitive weighted imaging. The detection rate of ischemic lesions by DWI was higher than the conventional MRI, and DWI could show cerebral white matter damage of premature infants much earlier than the conventional MRI. The detection rate of hemorrhage stove by susceptibility weighted imagingc （SWI） was hig- her than the conventional MRI （X2 = 23.78, P 〈 0.05 ）, and SWI could show hemorrhagic lesions much earlier than conventional MRI （X2 = 27.02,P 〈 0.05 ）. Conclusions MRI, especially combined multiple sequence checking, could provide accurate imaging evidence for the early diagnosis of brain injury in premature infants.
出处
《中华实用儿科临床杂志》
CAS
CSCD
北大核心
2015年第15期1180-1183,共4页
Chinese Journal of Applied Clinical Pediatrics
关键词
磁共振成像
婴儿
早产
脑损伤
临床
Magnetic resonance imaging
Premature infant
Brain injury
Clinic
