摘要
目的分析弥散张量成像在新生儿缺氧缺血性脑病早期诊断中的应用价值,为临床制定合理有效的诊治方案提供依据。方法选取足月新生儿缺氧缺血性脑病(HIE)20例为研究对象(轻度组10例,中重度组10例)。同期收集非HIE足月新生儿10例为对照组。轻度组、中重度组与对照组新生儿均于生后8-21天内进行磁共振扫描检查,获得DTI定量指标,如各向异性分数(FA)、径向扩散率(RD)、轴向扩散率(AD)和平均扩散率(MD),分析磁共振弥散张量成像(DTI)在足月新生儿HIE早期诊断中的价值,分析DTI定量指标能否评估HIE脑损伤的严重程度。结果中重度组右侧放射冠FA值较对轻度组降低,右侧颞枕叶、左侧顶枕叶交界区MD值较轻度组升高,右侧大脑脚、右侧额、顶叶、左侧顶叶、胼胝体压部RD值较轻度组增加,差异境外具有统计学意义(P<0.05)。轻度组左额叶下白质FA值较对照组升高,双侧额叶MD值、RD值较对照组降低,差异具有统计学意义(P<0.05)。结论DTI技术在新生儿HIE早期诊断中发挥重要作用;FA值、MD值、RD等DTI特征值可以量化评估HIE患儿脑损伤的范围及程度,能为临床提供较为准确的脑白质损伤情况。
Objective To analyze the application value of diffusion tensor imaging in the early diag⁃nosis of neonatal hypoxic ischemic encephalopathy,and to provide the basis for making reasonable and ef⁃fective clinical diagnosis and treatment.Methods Twenty full-term neonates with hypoxic ischemic en⁃cephalopathy(HIE)were selected as the study objects(10 cases in the mild group and 10 cases in the moderate and severe group).In the same period,10 full-term neonates without HIE were collected as con⁃trol group.The newborns in the mild group,moderate and severe group and control group were all exam⁃ined by magnetic resonance scanning within 8 to 21 days after birth to obtain DTI quantitative indexes,such as anisotropy fraction(FA),radial diffusivity(RD),axial diffusivity(AD)and mean diffusivity(MD).To analyze the value of magnetic resonance diffusion tensor imaging(DTI)in the early diagnosis of HIE in full-term neonates,and to analyze whether DTI quantitative index can evaluate the severity of brain inju⁃ry in HIE.Results The FA value of the right radiative crown in the moderate and severe group was lower than that in the mild group,the MD value of the right temporo-occipital lobe and the left parietal occipital junction area was higher than that in the mild group,and the RD value of the right peduncle,right frontal lobe,parietal lobe,left parietal lobe and corpus callosum were higher than that in the mild group,with sta⁃tistical significance(P<0.05).The FA value of left inferior frontal lobe in mild group was higher than that in control group,and the MD value and RD value of bilateral frontal lobe were lower than that in control group,the difference was statistically significant(P<0.05).Conclusions DTI technology plays an impor⁃tant role in the early diagnosis of neonates with HIE.DTI characteristic values such as FA value,MD val⁃ue and RD can quantitatively evaluate the scope and degree of brain injury in children with HIE,and can provide more accurate clinical white matter injury.
作者
于敏
李红新
Yu Min;Li Hong-Xin(Pediatric Internal Medicine Department,Changzhou Children's Hospital Affiliated to Nantong University,Changzhou 213003,Jiangsu Province,China)
出处
《常州实用医学》
2023年第3期161-167,共7页
CHANGZHOU PRACTICAL MEDICINE
基金
常州市卫健委科技项目,编号ZD201924。
关键词
弥散张量成像
新生儿缺氧缺血性脑病
诊断价值
diffusion tensor imaging
hypoxic-ischemic encephalopathy
diagnostic value
作者简介
通信作者:李红新。
