新生儿脑损伤的MRI表现及危险因素分析

目的探讨新生儿脑损伤MRI表现及危险因素。方法以本院2013年2月-2015年2月收治的40例新生儿脑损伤患儿为研究对象,均接受颅脑CT、MRI检查,观察MRI影像学表现,将其病灶异常检出率与CT检查对比;同时选择50例同期低血糖但无脑损伤新生儿为对照组,比较两组胎龄、分娩方式、血糖水平等情况,多因素Logistic回归分析新生儿脑损伤发生危险因素。结果 MRI发现脑损伤37例(92.50%)显著高于CT检查的30例(75.00%)(P0.05)。MRI发现37例患者中顶叶10例,枕叶12例,顶枕叶15例;均表现为DWI高信号、T1WI低信号,T2WI以高信号为主。Logistic多因素回归分析发现惊厥、低血糖水平(0.5-1.4 mmol/L)、低血糖持续时间24 h及脑电图异常为新生儿脑损伤独立危险因素。结论 MRI对新生儿脑损伤诊断检出率高,新生儿脑损伤危险因素包括惊厥、低血糖持续时间大24h、脑电图异常等,两者对疾病干预均有一定的指导作用。

Analysis of MRI Findings and Risk Factors of Neonatal Brain Injury

Objective To investigate the MRI findings and risk factors of neonatal brain injury. Methods 40 cases of neonates with brain injury who were treated in our hospital between February 2013 and February 2015 were selected as study subjects. All underwent brain CT and MRI examination. The MRI manifestations were observed.The detection rate of abnormal lesions was compared with that of CT, at the same time, 50 cases of neonates with hypoglycemia and without brain injury were selected as control group. The gestational age, delivery mode and blood glucose level were compared between the two groups. Multivariate Logistic regression analysis was performed to analyze the risk factors of neonatal brain injury. Results MRI found that there were abnormalities (brain injury) in 37 cases (92.50%) which were significantly higher than those detected by CT (30 cases and accounts for 75.00%) (P<0.05). MRI found that in 37 cases, there were 10 cases with lesions in the parietal lobe, 12 cases in occipital lobe and 15 cases in parietal-occipital lobe lobe, all manifested as high signal on DWI, low signal on T1WI and high signal on T2WI. Multivariate Logistic regression analysis showed that seizure, hypoglycemia level (0.5-1.4 mmol/L), duration of hypoglycemia>24h and abnormal EEG were the independent risk factors of neonatal brain injury. Conclusion MRI in the diagnosis of neonatal brain injury has a high detection rate. The risk factors of neonatal brain injury include seizure, duration of hypoglycemia>24h and EEG abnormalities, etc. Both of the two diagnostic methods have certain guiding effect in intervention of the disease.