新生儿缺氧缺血性脑损伤的磁共振成像波谱分析

发布时间：2018-04-10 16:34

本文选题：新生儿 + 缺氧缺血性脑损伤　；参考：《中国现代医学杂志》2017年18期

【摘要】：目的探讨新生儿缺氧缺血性脑损伤的磁共振成像波谱(MRS)分析。方法选取2013年9月-2016年9月该院确诊治疗的缺氧缺血性脑损伤新生患儿180例,依据病情严重程度分为轻度组(n=90)、中度组(n=50)及重度组(n=40),随访28 d,依据预后结果分为生存组(n=150)和死亡组(n=30),所有新生患儿均给予基于磁共振成像(MRI)的MRS检测氨酸及谷氨酞复合物α峰(CLx-α)、N-乙酰天门冬氨酸(NAA)、胆碱(Cho)、肌酸(Cr)及乳酸(Lac),采用受试者工作特征(ROC)曲线分析CLx-α/Cr值和Lac/Cr值对新生患儿预后的预测效能,统计分析所有新生患儿MRS检测结果情况。结果在NAA/Cr和NAA/Cho值方面,3组差异有统计学意义(P0.05)轻度组患儿高于中度组,中度组患儿高于重度组,在CLx-α/Cr和Lac/Cr值方面,3组差异有统计学意义(P0.05)。轻度组患儿低于中度组,中度组患儿低于重度组,差异有统计学意义(P0.05);生存组患儿CLx-α/Cr和Lac/Cr值低于死亡组,差异有统计学意义(P0.05);ROC曲线分析结果显示,CLx-α/Cr值以1.35为临界值时预测患儿死亡预后的敏感性、特异性及准确性分别为86.67%、90.00%及89.44%,Lac/Cr以1.35为临界值时预测患儿死亡预后的敏感性、特异性及准确性分别为83.33%、88.00%及87.22%,两者联合时预测患儿死亡预后的敏感性、特异性及准确性分别为93.33%、97.33%及97.78%,两者联合时预测患儿死亡预后的特异性、准确性高于单独CLx-α/Cr和Lac/Cr值时预测,差异有统计学意义(P0.05)。结论 MRS技术可有效无创检查缺氧缺血性脑损伤新生患儿脑代谢转变情况,有利于评估病情的严重程度,且联合CLx-α/Cr、Lac/Cr值可预测患儿预后,值得临床作进一步推广。
[Abstract]:Objective to study the magnetic resonance imaging spectroscopy (MRS) analysis of hypoxic ischemic brain injury in neonates.Methods 180 newborn children with hypoxic-ischemic brain injury were selected from September 2013 to September 2016.The 伪 -peak of the phthalein complex (CLx- 伪) was used to analyze the predictive effect of CLx- 伪 / Cr and Lac/Cr values on the prognosis of newborn children, including NAA, choline Cho, creatine (Cr) and Lactol lactate.The results of MRS test in all newborn children were statistically analyzed.Results there were significant differences in NAA/Cr and NAA/Cho values among the three groups (P0.05). The difference between mild group and moderate group was higher than that in severe group, and there was significant difference in CLx- 伪 -Cr and Lac/Cr value among three groups (P 0.05).The values of CLX- 伪 -Cr and Lac/Cr in the survival group were lower than those in the death group, the difference was statistically significant (P 0.05), and that in the mild group was lower than that in the moderate group, and in the moderate group was lower than that in the severe group.The difference was statistically significant (P 0.05).Conclusion MRS can effectively and noninvasively detect the brain metabolic transition in newborn children with hypoxic-ischemic brain injury, and it is helpful to evaluate the severity of the disease, and the combined CLx- 伪 / CrLac-Cr value can predict the prognosis of the neonates, which is worthy of further clinical application.
【作者单位】：哈励逊国际和平医院核磁共振室;
【基金】：河北省指令性课题计划(No:ZL20140001)
【分类号】：R445.2;R742

【相似文献】