【摘要】 目的采用磁共振成像(MRI)和磁共振波谱(1HMRS)对新生儿缺氧缺血性脑病(HIE)预后进行早期诊断,探讨其临床诊断价值及预后评估。方法选取2012年1月-2015年1月于该院确诊的足月HIE新生儿50例,将其作为HIE组,另选取足月无窒息史的新生儿50例作为对照组,对其临床资料进行回顾性分析,分别采用MRI与1HMRS对新生儿HIE预后进行早期诊断,以探讨其临床诊断价值及预后评估。结果经头颅MRI检查,HIE组新生儿出现6种早期异常现象,分别为皮层TIWI高信号、弥漫性脑颅出血、幕上脑水肿均数/叶数、蛛网膜下腔出血、白质TIWI高信号、双基底节区高信号伴随内囊后肢高信号消失,MRI均能较为清晰地显示;HIE组与对照组基底节兴趣区及额叶兴趣区胆碱复合物(Cho)/肌酸(Cr)、Cho/N-乙酰天门冬氨酶(NAA)及NAA/Cho比值进行比较,差异均具有统计学意义(t值分别为3.673、4.056、4.168;3.515、4.142、4.948,均P<0.05)。结论 MRI与1HMRS均能够对新生儿HIE预后进行很好的早期评估,能够客观反映足月新生儿HIE的脑代谢变化,有助于早期诊断新生儿HIE。更多还原

【Abstract】 Objective To ealy diagnose prognosis of neonatal hypoxic- ischemic encephalopathy( HIE) by magnetic resonance imaging( MRI) and magnetic resonance spectroscopy( 1HMRS),explore the clinical diagnostic value and prognosis evaluation. Methods Fifty full-term HIE neonates were selected from the hospital from January 2012 to January 2015 as HIE group,fifty full- term neonates without history of asphyxia were selected as control group. The clinical data was analyzed retrospectively,MRI and 1HMRS were used for early diagnosis of prognosis of neonatal HIE,the clinical diagnostic value and prognosis evaluation were analyzed. Results After cranial MRI examination,6 kinds of anomalies appeared in HIE group: high T1 WI signal of cortex,diffuse hemorrhage,supertentorial intracerebral edema mean / number of lobe,subarachnoid hemorrhage,white matter high T1 WI signal,bilateral basal ganglia high signal combined with disappearance of high signal of posterior limb of internal capsule,which were displayed clearly by MRI; there were statistically significant differences in choline containing compounds( Cho) / creatine( Cr),Cho / N- acetyl asparagine( NAA) and NAA / Cho ratios in basal ganglia region and frontal lobe between HIE group and control group( t = 3. 673,4. 056,4. 168,P < 0. 05; 3. 515,4. 142,4. 948,P < 0. 05).Conclusion Both MRI and 1HMRS can early evaluate prognosis and objectively reflect cerebral metabolic changes of HIE neonates,which is helpful to early diagnosis of neonatal HIE.更多还原