磁敏感加权成像评估早产儿脑损伤及预后

目的 探讨SWI对早产儿缺血缺氧性脑损伤早期诊断及预后评价的价值。方法 选取109例临床有明确围产期窒息史，于出生7天内首次接受MR检查的早产儿，2周及6个月后行MR复查，分析影像学表现。结果 109例早产儿存在不同程度脑损伤。其中单纯局灶性脑白质损伤34例，同时伴有生发基质-脑室内出血19例，单纯严重弥漫性脑白质损伤22例，同时伴有生发基质-脑室内出血14例，小脑、丘脑出血各8例，脑白质出血4例。脑白质损伤T1WI呈点片状高信号，T2WI呈低信号，DWI呈等高信号，SWI呈等、稍高信号；出血灶在T1WI为高信号，SWI为低信号。2周后MR复查示20例脑实质出血灶进展为软化囊腔。6个月后再次复查，34例单纯局灶性脑白质损伤和33例生发基质-脑室内出血患儿，SWI未明确显示病灶；22例严重弥漫性脑白质损伤和20例脑实质出血患儿，SWI清晰显示软化灶。结论 SWI对早产儿脑损伤的早期诊断和预后评价具有重要临床意义。

Susceptibility-weighted imaging evaluation of premature infants with brain damage and prognosis

Objective To study the early diagnostic and prognosis value of SWI in premature infant hypoxic-ischemic brain damage. Methods Totally 109 premature infants were examined with MRI within 7 days after birth, who were all followed-up after 2 weeks and 6 months. The imaging manifestations were analyzed. Results All cases existed brain damages: 34 cases with simple punctuate white matter lesions, 19 cases with punctuate white matter lesions and germinal matrix-intraventricular hemorrhage, 22 cases with simple diffuse white matter lesions, 14 cases with diffuse white matter lesions and germinal matrix-intraventricular hemorrhage, 8 cases with cerebellar hemorrhage, 8 cases with thalamic hemorrhage, 4 cases with the depth portion white matter hemorrhage. White matter lesions showed high signal on T1WI and DWI, low signal on T2WI, slightly high signal on SWI. Hemorrhage lesions showed high signal on T1WI and low signal on SWI. Followed-up after 2 weeks, 20 cases parenchymal hemorrhage had developed cysts malacia. Followed-up again after 6 months, 34 cases of simple focal cerebral white matter lesions and 33 cases of germinal matrix-children with intraventricular hemorrhage did not clearly show the lesions on SWI, 22 cases of severe diffuse brain white matter lesions and 20 cases of children with parenchymal hemorrhage showed softening oven clearly on SWI. Conclusion The early diagnosis and prognosis evaluation of SWI have important clinical significance in premature infants with brain damage and prognosis.