MRI在新生儿缺氧缺血性脑病中的随访价值

目的评价MRI对缺氧缺血性脑病(HIE)患儿新生儿期及神经后遗症期随访的价值。方法回顾性分析81例HIE新生儿期及神经后遗症期的常规MRI表现及影像结果。对81例HIE患儿进行2次以上头部MR复查,首次在新生儿期,第2次在4月~4岁。足月儿66例,早产儿15例。结果81例中,2次复查后MRI异常79例(97.5%)。其中:髓鞘化异常59例(72.8%),外部性脑积水53例(65.4%),脑软化26例(32.1%),脑萎缩25例(30.9%),脑白质减少24例(29.6%)及胼胝体发育不良9例(11.1%)。轻度者复查常为外部性脑积水(26/35例)及局限性髓鞘化异常(16/35例),而中度患儿则伴有脑软化灶(12/29例),重度患儿常见脑萎缩(16/17例)或脑白质减少(15/17例)。结论常规MRI可准确反映HIE及神经后遗症期脑的形态学改变,为HIE早期干预和评估预后提供了客观依据。

Neonatal Hypoxic-Ischemic Encephalopathy: Follow-up Value with MRI

Objective To study the follow-up value of MRI in the sequela hypoxic-ischemic encephalopathy(HIE).Methods MRI features of HIE in 81 neonates were analyzed retrospectively,every child had two cranial MRI scans,the first scan at the end of the newborn stage,the second scan at 4 months to 4 years.There were 66 full-term neonates and 15 preterm neonates.Results Of 81 cases,79 cases were abnormal on second MRI examination,including myelinogenetic abnormal in 59 cases(72.8%),external hydrocephalus(EH) in 53 cases(65.4%),brain malacia in 26 cases(32.1%),cerebaral atrophy in 25 cases(30.1%),white matter decrease in 24 cases(29.6%) and dysplasia of corpus callosum in 9 cases(11.1%).EH(26/35cases) and myelinogenetic abnormal(16/35 cases) in mild HIE group,brain malacia(12/29 cases) in moderate HIE group,cerebaral atrophy(16/17 cases) and white matter decrease(15 /17 cases)in severe HIE group were often seen.Conclusion MRI findings can reflect the pathological changes of sequela of HIE,and provide objective basis for diagnosis and assessment of prognosis.