颅脑超声及磁共振弥散加权成像对早产儿脑白质损伤的诊断价值

目的 分析早产儿脑白质损伤(WMI)的颅脑超声及磁共振弥散加权成像(DWI)特点,探讨其在WMI早期诊断及随访中的应用价值.方法 回顾性分析我院2018年1月至2020年2月疑诊为WMI的120例早产儿临床资料,分析颅脑超声及DWI的检查结果及诊断价值.结果 120例患儿,临床确诊为WMI 112例,脑积水6例,胼胝体...

Diagnostic value of brain ultrasound and magnetic resonance diffusion weighted imaging in preterm infants with white matter injury

Objective To analyze the characteristics of cranial ultrasound and magnetic resonance diffusion weighted imaging(DWI)in preterm infants with white matter injury(WMI),and to explore their application value in early diagnosis and follow-up of WMI.Methods The clinical data of 120 premature infants suspected with WMI in our hospital from January 2018 to February 2020 were retrospectively analyzed,and the results and diagnostic value of craniocerebral ultrasound and DWI were analyzed.Results Among the 120 children,112 were diagnosed with WMI,6 with hydrocephalus and 2 with corpus callosum dysplasia.Based on clinical diagnosis,98 cases(87.50%)of WMI were accurately diagnosed by craniocerebral ultrasound.Taking choroid plexus echo as reference standard and according to the degree of periventricular echo enhancement(PVE)in the first examination,38 cases were classified into gradeⅠ,32 cases into gradeⅡ,and 28 cases into gradeⅢ,while 14 cases were missed and misdiagnosed(12.50%).A total of 78 cases(69.64%)of WMI were accurately diagnosed by conventional MRI,including 52 cases of focal lesions,4 cases of diffuse lesions,22 cases of periventricular leukomalacia(PVL),and 34 cases of missed diagnosis or misdiagnosis(30.36%).By conventional MRI+DWI,a total of 102 cases(91.07%)of WMI were accurately diagnosed,including 46 cases of focal lesions,34 cases of diffuse lesions,22 cases of PVL,and 10 cases of missed diagnosis or misdiagnosis(8.93%).Conclusion Both craniocerebral ultrasound and DWI can make accurate diagnosis of WMI.Craniocerebral ultrasound is convenient and reproducible,and it is the first choice for preliminary screening and follow-up of WMI.