磁共振扩散张量成像在缺血缺氧脑病患儿中的临床应用

目的探讨磁共振扩散张量成像(DTI)在缺血缺氧脑病患儿中的应用价值。方法前瞻性纳入2016-12—2018-12于河南中医药大学第一附属医院行MRI头颅平扫及DTI检查的年龄<2岁患儿40例,所有患儿在围生期均有缺氧缺血脑病史,根据最终随访结果分为脑瘫组及非脑瘫组各20例。测量双侧大脑脚、内囊前肢、内囊膝部、内囊后肢、半卵圆中心、皮质脊髓束、下纵束、丘脑后辐射、额叶白质、顶叶白质、胼胝体膝部、胼胝体体部及胼胝体压部的FA值。结果2组间双侧大脑脚、内囊后肢、半卵圆中心、皮质脊髓束、下纵束、丘脑后辐射、顶叶白质、胼胝体膝部、胼胝体体部、胼胝体压部FA值差异均有统计学意义(P<0.05),而双侧内囊前肢、内囊膝部、额叶白质FA值差异无统计学意义(P>0.05)。结论DTI可以定量评估缺血缺氧脑病患儿的损伤程度,有助于早期评估病情及预测预后。

The application of diffusion tensor imaging in children with ischemia and hypoxia

Objective To evaluate the application value of magnetic resonance diffusion tensor imaging in quantitative evaluation of brain injury in children with hypoxic ischemia.Methods Forty children younger than 2 years underwent MR brain plain and DTI scan in the First Affiliated Hospital of Henan University of Traditional Chinese Medicine were enrolled in this prospective cohort study from December 2016 to December 2018.All children have a history of hypoxia and ischemia in the perinatal period.According to the follow-up results,they were divided into cerebral palsy group(n=20)and non cerebral palsy group(n=20).Measured FA values includeBilateral cerebral peduncle,anterior limb of internal capsule,genu of internal capsule,posterior limb of internal capsule,centrum semiovale,corticospinal tract,inferior longitudinal fasciculus,posterior radiation of thalamus,white matter of frontal lobe,white matter of parietal lobe,genu of corpus callosum,body of corpus callosum and splenium of corpus callosum.Results The FA values between the two groups were statistically significant in bilateral cerebral peduncle,posterior limb of internal capsule,centrum semiovale,corticospinal tract,inferior longitudinal fasciculus,posterior radiation of thalamus,white matter of parietal lobe,genu of corpus callosum,body of corpus callosum and splenium of corpus callosum(P<0.05),and there was no significant difference in bilateral anterior limb of internal capsule,genu of internal capsule and white matter of frontal lobe(P>0.05).Conclusion DTI can quantitatively evaluate the degree of injury in children with hypoxic-ischemic brain injury,which is helpful for early assessment of the severity and prediction of prognosis.