3.0T磁共振SWI及MRS在新生儿HIE早期诊断中的应用价值

目的分析3.0T磁共振头颅波谱成像(MRS)及磁敏感加权成像(SWI)在新生儿缺氧缺血性脑病(HIE)早期诊断中的应用价值。方法选取2017年11月-2018年5月于我院新生儿科确诊的HIE患儿65例,通过3.0T磁共振扫描仪对患儿进行MRS及SWI,比较头颅常规MRI序列与SWI序列对HIE患儿的检出率,同时观察MRI序列与SWI序列对HIE患儿出血灶及静脉扩张检出率以及SWI与MRS检出损伤脑叶数。结果60例新生儿HIE SWI检出率为92.31%,MRS检出率为98.46%,不同临床分度新生儿HIE患者SWI与MRS检出例数差异均无统计学意义(P>0.05);SWI的HIE重度组出血灶及静脉扩张检出率高于中度和轻度组,中度高于轻度组,差异具有统计学意义(P<0.05);MRS对不同临床分级HIE出血灶及静脉扩张检出率均较低,SWI与MRS间对不同HIE分度患儿出血灶及静脉扩张检出率差异具有统计学意义(P<0.05);轻度HIE患儿中>2个脑叶以及≤2个脑叶SWI与MRS检出损伤脑叶数差异具有统计学意义(P<0.05);中度与重度患儿>2个脑叶以及≤2个脑叶SWI与MRS检出损伤脑叶数差异均无统计学意义(P>0.05)。结论 3.0T磁共振SWI及MRS作为近年来磁共振新开发的成像技术,对新生儿颅内出血具有高度敏感性。二者具有各自的优势,联合使用在判断出新生儿脑损伤的严重程度上具有重要意义。

The value of 3.0T Magnetic Resonance SWI and MRS in Early Diagnosis of Neonatal HIE

Objective To investigate the value of 3.0 T magnetic resonance imaging(MRS) and magnetic sensitive weighted imaging(SWI) image indexing in the early diagnosis of neonatal hypoxic ischemic encephalopathy(HIE). Methods Sixty-five children with HIE diagnosed in neonatology from November 2017 to May 18, 2017 were enrolled. The MRS and magnetic SWI of the children were scanned by 3.0 T magnetic resonance scanner. The conventional MRI sequence and SWI sequence were compared to HIE. The detection rate of the children, while observing the MRI sequence and SWI sequence for HIE children with hemorrhagic lesions and venous dilatation detection rate and SWI and MRS detected the number of damaged brain lobes. Results The detection rate of HIE SWI in 60 neonates was 92.31%, and the detection rate of MRS was 98.46%. There was no significant difference in the number of cases detected by SWI and MRS in neonates with different clinical grades of HIE(P>0.05). The detection rate of hemorrhagic foci and venous dilatation in HIE severe group of SWI was higher than that in moderate and mild group, moderately higher than mild group, the difference was statistically significant(P<0.05). MRS had a lower detection rate of HIE hemorrhagic foci and venous expansion in different clinical grading. There was a statistically significant difference in the detection rate of hemorrhagic foci and venous dilatation between children with different HIE scores between SWI and MRS(P<0.05). Among the children with mild HIE, >2 brain lobe and ≤2 brain lobe, the difference in the number of brain injured lobe detected by SWI and MRS was statistically significant(P<0.05). Among the children with moderate and severe HIE, > 2 brain lobe and ≤ 2 brain lobe, and there were no significant difference in the number of brain injured lobe detected by SWI and MRS(P>0.05). Conclusion 3.0 T magnetic resonance SWI and MRS are newly developed imaging techniques in recent years and are highly sensitive to neonatal intracranial hemorrhage. The two have their own advantages, and the combined use is of great significance in judging the severity of neonatal brain injury.