磁共振成像对新生儿脑白质弥漫性高信号的诊断及预后评估

目的：探讨磁共振成像(magnetic resonance imaging，MRI)对新生儿脑白质弥漫性高信号(diffuse excessive high signal intensity，DEHSI)的诊断及预后评估的价值。材料与方法通过对比和随访不同类型DEHSI患儿常规MRI特征性表现、脑白质病灶演变过程及患儿神经心理发育结果，分析三者之间的内在联系。结果生后年龄、胎龄、头围与DEHSI评估之间呈显著负相关(r=－0.266、－0.303、－0.200，P均＜0.05)。DEHSI的严重程度与矫正年龄后5个月大的患儿的各项预后指标评分(ADQ、GMDQ、FMDQ、LDQ、PSDQ)呈负相关(r=－0.423、－0.499、－0.553、－0.317、－0.453，P均＜0.05)。结论宫外暴露时间可促进新生儿成熟；此外，胎龄越大，胎儿越成熟，DEHSI分级越低。MRI可区分不同分级的DEHSI及较好的评价预后，中重度DEHSI患儿预后较差，无或轻度DEHSI患儿预后较好。

Magnetic resonance imaging for the diagnosis and prognosis of neonatal cerebral white matter diffuse excessive high signal intensity

Objective:To explore the value of magnetic resonance imaging (MRI) in the diagnosis and prognosis of neonatal cerebral white matter diffuse excessive high signal intensity (DEHSI).Materials and Methods:To compare and analyze the typical features in MRI, the process of cerebral white matter lesions and the neurodevelopmental outcomes of neonates.Results:Postnatal age, gestational age, head girth had a signiifcantly negative correlation with DEHSI(r=-0.266,-0.303,-0.200, allP<0.05). There was a negative correlation between the grade of DEHSI and the Gesell scores (ADQ, GMDQ, FMDQ, LDQ, PSDQ) of infants at 5 month corrected age (r=-0.423,-0.499,-0.553,-0.317,-0.453, allP<0.05). Conclusion:Extrauterine exposure time could promote the degree of prematurity in infants. In addition, the long time stay in intrauterine, the higher the maturity, and the lower grade of DEHSI. MRI could distinguish the different grades of DEHSI and assess the neurodevelopmental outcomes. The neurodevelopmental outcomes was poor in moderate-sereve DEHSI of infants, which was good in infants with no or mild DEHSI.