MRI在新生儿缺氧缺血性脑病中的应用

目的探讨新生儿窒息后所致缺氧缺血性脑病的脑损伤。方法对于４３例生后１０天内新生儿进行头颅ＭＲＩ检查，其中７例正常新生儿，３６例为缺氧缺血性脑病（ＨＩＥ）。结果根据ＭＲＩ影像特点将ＨＩＥ脑损伤分为：（１）脑实质水肿改变为主：①广泛脑水肿伴基底节区损伤：８／３６；②局灶性脑水肿伴基底节区损伤：１１／３６；③单纯性脑水肿：７／３６。（２）以脑白质改变为主：５／３６。（３）脑实质出血：４／３６，脑室旁梗塞继发出血１／３６，并且对１２例患儿进行随访，其中６例伴基底节区损伤患儿于６个月～１岁时ＭＲＩ仍可见异常Ｔ２低信号或Ｔ２高信号，１例脑室旁梗塞继发出血患儿于８个月时原发病灶呈Ｔ２高信号及Ｔ１低信号病灶信号。结论ＭＲＩ对基底节区微小病灶具有高度敏感性，有助于ＨＩＥ脑损伤的研究并指导治疗及评估预后

Magnetic resonance imaging (MRI) in neonatal hypoxic ischemic encephalopathy

Objective To identify the pattern of brain injury in neonates with hypoxic ischemic encephalopthy (HIE). Methods MRI was performed in 36 neonates with HIE and 7 normal newborns within 10 days of life. Results The most common findings in the MRI were cerebral edema, diffuse brain edema with thalamus and basal ganglia lesion in 8 cases, local brain edema with thalamus and basal ganglia lesion in 11 cases, primary cerebral edema in 7 neonates. Periventricular white matter change was identified in 5 cases; cerebral hemorrhage was found in 4 cases and cerebral infarct hemorrhage in 1 out of the 12 neonates who were followed up at 6 12 months, 6 with thalamus and basal ganglia lesion still had abnormal T 2 hyper or hypo intense lessions, while the case with periventricular infarct hemorrhage had an abnormal T 2 hyperintense and T 1 hypointense. Conclusion MRI is highly sensitive for micro hemorrhage and necrosis, it is also useful for research on HIE, decision making for therapeutic options and evaluation of prognosis of patients.