扩散加权成像技术在HIE诊断中的临床应用

目的研究扩散加权成像技术在新生儿缺氧缺血性脑病（HIE）诊断中的临床应用。方法将96例临床确诊为HIE的患儿随机分为A组和B组,A组采用常规核磁检查,B组采用扩散加权成像技术检查。观察两组患儿生后24h（早期）和生后1周（亚急性期）缺氧性脑损伤的阳性率,并随访患儿的预后。结果两组患儿一般情况比较差异无统计学意义（P〈0.05）。在HIE发病早期,A组阳性率为37.5%,B组阳性率为80.0%,两组比较差异有统计学意义（P〈0.05）;在HIE发病亚急性期,A组阳性率为100%,B组阳性率为100%,两组比较差异无统计学意义（P〉0.05）。A组检出影像学变化21例,随访预后不良7例;B组检出影像学变化32例,随访预后不良19例,B组对HIE患儿的预后评估价值明显高于A组（P〈0.05）。结论扩散加权成像主要反映HIE早期病理变化,可发现早期脑损害,利于临床治疗。常规核磁反映亚急性期病变较好,适宜做随访检查。

Application of diffusion-weighted imaging in the diagnosis of HIE

Objective To study the application of diffusion-weighted imaging in the diagnosis of hypoxie-ischemic encephalopathy（HIE）. Methods 96 patients with clinically diagnosed HIE patients were randomly divided into 2 groups：group A was diagnosed with conventional magnetic resonance imaging examination; group B was diagnosed with diffusion-weighted imaging examination. Images were observed at 24 h after birth （early） and in postnatal week （subacute） for hypoxic brain injury. And the prognosis of children was followed-up. Results The general condition of two groups of children showed a statistically significant difference（P0.05）. In the early onset of HIE, the positive rate of group B （80%） was significantly higher than that of group A 37.5%（P0.05）. In the subacute onset of HIE, the positive rates of group A and group B were both 100%. In group A, 21 cases were detected with imaging changes, of which 7 cases were followed up for a poor prognosis. In group B 32 cases were detected with imaging changes, of which 19 cases were followed up for a poor prognosis.The prognostic value of HIE infants in group B was significantly higher than that of group A（P0.05）. Conclusions Diffusion-weighted imaging reflects the early pathological changes of HIE in early brain damage, and has clinical benefit. Conventional magnetic resonance imaging better reflects the subacute lesion, and is suitable for follow-up examination.