新生儿颅脑常见弥散受限类疾病的MRI特点

目的探讨新生儿颅脑磁共振成像(MRI)出现弥散受限病变时的影像特点,提高对此类疾病的诊断及鉴别诊断水平。方法收集我院颅脑MRI出现弥散受限病变的新生儿127例,回顾性分析其弥散序列及常规序列特点。结果经临床证实,共包括新生儿缺氧缺血性脑病(HIE)84例、新生儿低血糖脑病30例、新生儿脑梗死13例;新生儿HIE根据MRI表现分轻、中、重三度,均表现为对称性弥散受限信号,但弥散受限范围及强度小于T₁WI,常伴颅内出血且重度均累及深部灰质核团;新生儿低血糖脑病弥散受限常见于枕顶叶,皮髓质均受累,双侧对称或者不对称,其中20例皮髓质交界见线状T₁WI高信号;新生儿脑梗死弥散受限位于一侧大脑半球,呈楔形改变,左侧大脑中动脉供血区常见,可累及同侧内囊前后肢、丘脑及大脑脚,其中11例皮髓质交界见线状T₁WI高信号。结论新生儿HIE、新生儿低血糖脑病、新生儿脑梗死MRI表现具有一定特点,结合临床病史可对此类疾病进行诊断及鉴别诊断。

MRI Features of Common Diffusion-Limited Diseases in Neonatal Craniocerebral

Objective To investigate the imaging features of neonatal craniocerebral magnetic resonance imaging(MRI)when signs of restricted diffusion are found in the intracranial MRI of neonatal craniocerebrals,so as to improve the level of imaging diagnosis and differential diagnosis of this kind of disease.Methods A total of 127 neonates cases with diffusion-limited lesions on the brain MRI in our hospital were collected and retrospectively analyzed for the characteristics of diffusion and conventional sequences.Results According to clinical confirmation,there were 84 cases of neonatal hypoxicischemic encephalopathy(HIE),30 cases of neonatal neonatal hypoglycemic encephalopathy and 13 cases of neonatal cerebral infarction.On the basis of the findings,neonate HIE was classified into light,medium and heavy degrees that all have abnormal signals in diffusion sequence and the signals were bilateral symmetry,but the range and intensity of diffusion-limited were less than T₁WI,often accompanied by intracranial hemorrhage and severely involved in the deep gray nuclei.Restricted diffusion lesions of neonatal hypoglycemic encephalopathy were commonly found in parietal and occipital lobes,with cortex and medulla involved,bilateral symmetry or asymmetry,among which 20 cases showed linear T₁WI high signal at the junction of cortex and medulla.the neonatal diffusion lesion of cerebral infarction was located in one side of the cerebral hemisphere and presents a wedge-shaped change which was more commonly seen on the blood supply area of left middle cerebral artery and could involve ipsilateral internal capsule anterior and posterior limb,thalamus and pedunculus cerebri,among which 11 cases showed linear T₁WI high signal at the junction of cortex and medulla.Conclusion The MRI findings of neonatal HIE,neonatal hypoglycemia encephalopathy and neonatal cerebral infarction have certain features,which can be diagnosed and differentiated by combining with clinical history.