早产儿脑损伤的常规MRI和DTI初步研究

发布时间：2018-07-14 07:12

【摘要】：研究目的:通过对早产儿进行常规MRI、DTI检查，探讨早产儿脑损伤的常规MRI表现特征，并评价DTI在早产儿脑损伤中的价值。材料和方法:自2009年3月至2012年3月对127例早产儿行常规MRI、DWI和DTI检查，成像仪器为1.5T GE HD MR扫描仪，根据早产儿接受MRI检查时的纠正胎龄是否达到37周（259天）分为早产儿未足月组、早产儿足月组。剔除标准：1）早产儿出生后短时间内转院各种因素造成失访；2）各种原因造成图像不能分析。所有研究对象来自我院新生儿监护室（NICU）及爱婴中心。对常规MRI、DWI、DTI异常信号影进行分析，并运用Functool软件自动计算出ROI的ADC、FA值，用SPSS进行处理。结果:共66例早产儿纳入本研究，根据MRI表现，进一步将有异常表现的早产儿分为未足月患儿组（14例，胎龄226.4±16.1d，纠正胎龄249.7±8.3d）、足月患儿组（10例，胎龄235.1±18.8d，纠正胎龄276.6±9.3d），将正常表现的早产儿分为未足月对照组（14例，胎龄225.4±17.1d，纠正胎龄249.5±8.3d）；足月对照组（14例，胎龄234.8±18.8d，纠正胎龄275.7±9.3d）；MRI检查时间为2~57天。检查时早产儿足月患儿组的纠正胎龄与早产儿足月对照组的纠正胎龄相当（t=0.648，P=0.533）；早产儿未足月患儿组的纠正胎龄与早产儿未足月对照组的纠正胎龄相当（t=2.710，P=0.128）。（1）早产儿脑损伤在常规MRI共检出56例，其中脑水肿（轻、中度）10例，颅内出血16例，室周围脑白质损伤6例，54例DEHSI。（2）各组组内双侧大脑半球相对应ROI的ADC、FA值均无统计学差异；但不同部位之间的ADC、FA值均有统计学差异（P0.05）。（3）组间比较：ADC值：足月对照组与足月患儿组之间额叶ADC值存在统计学意义（t=-9.055，P=0.000）。未足月患儿组与未足月对照组之间豆状核ADC值存在统计学意义（t=2.263，P=0.032）。FA值：足月对照组与足月患儿组之间内囊后肢的FA值有统计学意义（t=-3.075，P=0.005）；足月对照组与足月患儿组之间额叶的FA值有统计学意义（t=2.486，P=0.022）。未足月患儿组与未足月对照组之间各部位没有统计学意义（P㧐0.05）。结论:1、常规MRI能显示多种类型的早产儿脑损伤。 2、DTI对检出早产儿脑损伤有价值，ADC、FA值能提供定量信息。
[Abstract]:Objective: to investigate the MRI features of brain injury in premature infants and evaluate the value of DTI in preterm infants by routine MRI DTI. Materials and methods: from March 2009 to March 2012, 127 premature infants were examined with conventional MRI DWI and DTI with 1.5T GE HD Mr scanner. According to whether the corrected gestational age reached 37 weeks (259 days), premature infants were divided into preterm group and preterm group. Excluding the standard of: 1) all factors caused by the transfer of preterm infants within a short period of time after birth (2) all kinds of reasons can not be analyzed. All subjects were from NICU and baby-friendly center. The abnormal signal shadow of conventional MRI DWI / DTI was analyzed, and the ADCF value of ROI was calculated automatically by using Functool software and processed by SPSS. Results: a total of 66 premature infants were included in this study. According to the MRI findings, the preterm infants with abnormal findings were further divided into two groups: the unmature infants group (14 cases, gestational age 226.4 卤16.1d, corrected gestational age 249.7 卤8.3d), and the term infants group (10 cases). The normal preterm infants were divided into control group (14 cases, gestational age 225.4 卤17.1 d, corrected gestational age 249.5 卤8.3 d) and full-term control group (14 cases, gestational age 234.8 卤18.8 d, corrected gestational age 275.7 卤9.3 d). The corrected gestational age of preterm infants in term group was equal to that in term control group (t = 0.648p = 0.533). The corrected gestational age of preterm infants was similar to that of premature infants without term control (t = 2.710p = 0.128). (1). 56 cases of brain injury were detected by routine MRI, including 10 cases of cerebral edema (mild and moderate) and 16 cases of intracranial hemorrhage. There were 6 cases of periventricular white matter injury and 54 cases of DEHSI. (2) there was no significant difference in ADCFA values of bilateral cerebral hemispheres corresponding to ROI in each group. However, there were significant differences in ADCA FA values between different sites (P0.05). (3): there was significant difference in ADC values between term control group and full-term group (t = 9.055U, P = 0.000). The ADC value of lentiform nucleus was significantly different between the non-term group and the non-term control group (t = 2.263). FA value was statistically significant between the term control group and the term control group (t = 3.075, P = 0.005). The FA value of frontal lobe in term control group and term group was statistically significant (t = 2.486, P = 0.022). There was no statistical difference between the unfull-term group and the control group (P0. 05). Conclusion conventional MRI can show various types of brain injury in premature infants, and DTI can provide quantitative information for the detection of brain injury in premature infants.
【学位授予单位】：暨南大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R722.6

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