扩散张量成像FA值在新生儿HIE早期诊断及预后判断中的价值
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摘要
目的分析扩散张量成像(DTI)的各向异性分数(FA)值在新生儿缺氧缺血性脑病(HIE)早期诊断中的临床应用价值。方法选取该院2015年5月至2018年5月收治的45例HIE新生儿作为观察组,按照病情轻重分为轻度组18例,中度组12例,重度组15例,另选择同期该院体检健康新生儿15例作为对照组,所有研究对象均采用3.0T超导型MRI仪行颅脑MRI常规序列及DTI序列扫描。测量并比较各组研究对象颅脑各个感兴趣区内的FA值。结果观察组额叶深部髓质、顶枕叶深部髓质、小脑半球、脑干、内囊后肢、豆状核区、丘脑的平均FA值低于对照组,差异均有统计学意义(P<0.05)。且上述感兴趣区平均FA值在对照组、轻度组、中度组、重度组中依次降低,两两比较,差异均有统计学意义(P<0.05)。结论采用DTI的FA值可早期诊断并评估新生儿HIE的预后。
Objective To explore and analyze the clinical application value of diffusion tensor imaging(DTI)anisotropic fraction(FA)in the early diagnosis of neonatal hypoxic ischemic encephalopathy(HIE).Methods A total of 45 patients of neonatal HIE in Hunan Provincial Maternal and Child Health Care Hospital from May 2015 to May 2018 were selected into observation group,then divided into mild group(18 cases),moderate group(12 cases)and severe group(15 cases)according to the state of illness,meanwhile 15 healthy neonatals were recruited into control group.All the objects were given regular 3.0 Tmagnetic resonance cerebral MRI sequence and sequence of DTI scan.FA value was measured in all interest areas of the brain in the mild group,moderate group,severe group and control group.Results Compared with the control group,the average FA values of deep medulla of the frontal lobe,deep medulla of the parietal occipital lobe,cerebellar hemisphere,brainstem,posterior ramus of the internal capsule,pacliform nucleus and thalamus of the observation group were all lower,with statistically significant differences(P<0.05).The average FA values of the interest areas above decreased gradually in control group,mild group,moderate group and severe group,with statistically significant differences(P<0.05).Conclusion The FA value of DIT can be used as an objective basis for early diagnosis and assessment of prognosis of neonatal HIE.
Objective To explore and analyze the clinical application value of diffusion tensor imaging(DTI)anisotropic fraction(FA)in the early diagnosis of neonatal hypoxic ischemic encephalopathy(HIE).Methods A total of 45 patients of neonatal HIE in Hunan Provincial Maternal and Child Health Care Hospital from May 2015 to May 2018 were selected into observation group,then divided into mild group(18 cases),moderate group(12 cases)and severe group(15 cases)according to the state of illness,meanwhile 15 healthy neonatals were recruited into control group.All the objects were given regular 3.0 Tmagnetic resonance cerebral MRI sequence and sequence of DTI scan.FA value was measured in all interest areas of the brain in the mild group,moderate group,severe group and control group.Results Compared with the control group,the average FA values of deep medulla of the frontal lobe,deep medulla of the parietal occipital lobe,cerebellar hemisphere,brainstem,posterior ramus of the internal capsule,pacliform nucleus and thalamus of the observation group were all lower,with statistically significant differences(P<0.05).The average FA values of the interest areas above decreased gradually in control group,mild group,moderate group and severe group,with statistically significant differences(P<0.05).Conclusion The FA value of DIT can be used as an objective basis for early diagnosis and assessment of prognosis of neonatal HIE.
引文
[1]王刚.血清细胞因子检测对新生儿缺氧缺血性脑病诊治的意义[J].检验医学与临床,2015,12(2):209-212.
[2]李红新,张琴芬,江凯华,等.磁共振弥散张量成像在足月窒息新生儿预后评估中的作用[J].中华实用儿科临床杂志,2017,32(18):45-46.
[3]赵友谊,张晓兰,丁敏,等.循证护理干预对新生儿缺氧缺血性脑病智能发育的影响[J].检验医学与临床,2017,14(6):841-843.
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[6]王剑,漆剑频,石晶晶,等.足月新生儿缺氧缺血性脑病的磁共振扩散张量成像研究[J].临床放射学杂志,2016,35(7):67-68.
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[9]贾系群,刘翠青.振幅整合脑电图与新生儿缺氧缺血性脑病临床分度及头颅磁共振成像表现的相关性分析[J].中国医师进修杂志,2015,38(8):90-91.
[10]邢可舟,孔晓勤,葛亚平,等.新生儿缺氧缺血性脑病的磁共振弥散张量成像及动脉自旋标记技术的诊断价值研究[J/CD].中华脑科疾病与康复杂志(电子版),2016,6(1):90-91.
[11]毛俊月,孙艳秋,张永海.功能磁共振成像在脑结核瘤诊断中的应用研究进展[J].山东医药,2016,56(14):45-46.
[12]李麦福.3.0T磁共振扩散张量成像在评估急性缺血性脑梗死及预后判断中的诊断价值[J].中国实用神经疾病杂志,2017,20(8):48-50.
[13]谢志玉,姚宝珍.磁共振弥散加权和弥散张量成像在新生儿脑梗死诊断及预后评估中的应用价值[J].中国实验诊断学,2017,21(7):34-35.
[14]杨蓓,金朝林,张树桐.弥散加权成像及1H磁共振波谱在新生儿缺氧缺血性脑病中的价值[J].中国妇幼保健,2014,29(32):456-457.
[15]杜奕,李艳,陈志强,等.磁共振波谱诊断新生儿缺氧缺血性脑病的临床价值[J].宁夏医科大学学报,2014,36(5):56-57.
[2]李红新,张琴芬,江凯华,等.磁共振弥散张量成像在足月窒息新生儿预后评估中的作用[J].中华实用儿科临床杂志,2017,32(18):45-46.
[3]赵友谊,张晓兰,丁敏,等.循证护理干预对新生儿缺氧缺血性脑病智能发育的影响[J].检验医学与临床,2017,14(6):841-843.
[4]姚灵生,冷晓明.1H-MRS联合磁共振弥散张量成像诊断HIE患儿的临床效果分析[J].中国CT和MRI杂志,2017,15(2):21-23.
[5]胡胜伟,陈勇华,陈清平,等.磁共振常规系列及DWI对新生儿缺氧缺血性脑病早期诊断及预后评估的价值探讨[J].基层医学论坛,2017,21(19):245-246.
[6]王剑,漆剑频,石晶晶,等.足月新生儿缺氧缺血性脑病的磁共振扩散张量成像研究[J].临床放射学杂志,2016,35(7):67-68.
[7]向葵,干芸根,王宏伟,等.扩散张量成像各向异性分数在足月新生儿缺氧缺血性脑病中的应用[J].中国医学影像学杂志,2016,24(4):248-249.
[8]贾爱英.磁共振不同扫描技术在新生儿缺血缺氧性脑病中的应用[J].现代医用影像学,2014,23(1):123-124.
[9]贾系群,刘翠青.振幅整合脑电图与新生儿缺氧缺血性脑病临床分度及头颅磁共振成像表现的相关性分析[J].中国医师进修杂志,2015,38(8):90-91.
[10]邢可舟,孔晓勤,葛亚平,等.新生儿缺氧缺血性脑病的磁共振弥散张量成像及动脉自旋标记技术的诊断价值研究[J/CD].中华脑科疾病与康复杂志(电子版),2016,6(1):90-91.
[11]毛俊月,孙艳秋,张永海.功能磁共振成像在脑结核瘤诊断中的应用研究进展[J].山东医药,2016,56(14):45-46.
[12]李麦福.3.0T磁共振扩散张量成像在评估急性缺血性脑梗死及预后判断中的诊断价值[J].中国实用神经疾病杂志,2017,20(8):48-50.
[13]谢志玉,姚宝珍.磁共振弥散加权和弥散张量成像在新生儿脑梗死诊断及预后评估中的应用价值[J].中国实验诊断学,2017,21(7):34-35.
[14]杨蓓,金朝林,张树桐.弥散加权成像及1H磁共振波谱在新生儿缺氧缺血性脑病中的价值[J].中国妇幼保健,2014,29(32):456-457.
[15]杜奕,李艳,陈志强,等.磁共振波谱诊断新生儿缺氧缺血性脑病的临床价值[J].宁夏医科大学学报,2014,36(5):56-57.