磁敏感加权成像与常规磁共振序列诊断新生儿颅内出血的比较研究

发布时间：2018-06-22 22:35

本文选题：磁共振成像 + 新生儿　；参考：《中国循证儿科杂志》2015年02期

【摘要】：目的探讨磁敏感加权成像(SWI)在新生儿颅内出血的应用价值。方法纳入2009年8月至2011年2月复旦大学附属儿科医院NICU临床疑诊脑损伤的新生儿,同时进行常规MRI和SWI扫描。分为足月儿组和早产儿组,统计常规MRI和SWI检测的出血部位、出血病灶数目和出血面积的差别。结果 596例临床疑诊脑损伤的新生儿进入分析。1常规MRI检出颅内出血117例(19.6%),早产儿组72例(61.5%);SWI检出颅内出血134例(22.5%),早产儿组81例(60.4%),包括生发基质出血40例(早产儿33例,足月儿7例),侧脑室出血68例(早产儿54例,足月儿14例),脉络丛出血30例(早产儿18例,足月儿12例),第三脑室出血6例(早产儿),中脑导水管出血3例(早产儿),第四脑室出血27例(早产儿23例,足月儿4例),大脑实质出血22例(早产儿14例,足月儿8例),小脑出血20例(早产儿11例,足月儿9例),脑干出血1例(足月儿),蛛网膜下腔出血10例(早产儿4例,足月儿6例),硬膜下出血36例(早产儿17例,足月儿19例),硬膜外出血2例(足月儿)。2生发基质-脑室内出血(6个部位)中,除了中脑导水管出血外,其他5个部位的出血病灶检出数目SWI均大于常规MRI(P均0.05)。SWI对蛛网膜下腔出血的检出数目大于常规MRI(P0.05);对硬膜下出血和硬膜外出血的检出数目上,SWI和MRI差异无统计学意义(P0.05)。3SWI序列81例早产儿生发基质-脑室出血主要为生发基质出血(44个)、侧脑室出血(90个)和脉络丛出血(26个);53例足月儿生发基质-脑室出血以侧脑室出血(23个)和脉络丛出血(18个)多见。498例在SWI和常规MR同时显示出血的病例,颅内出血(生发基质-脑室内出血、大脑和小脑实质出血)面积(cm2)SWI均大于常规MRI的T2WI序列,(0.69±0.63)vs(0.49±0.48),P0.001。结论 SWI较常规MRI在检出新生儿各种类型的颅内出血和蛛网膜下腔出血的阳性率、病灶数目和出血面积方面有明显的优势,可作为常规MRI的有力补充。
[Abstract]:Objective to evaluate the value of magnetic sensitivity weighted imaging (SWI) in neonatal intracranial hemorrhage. Methods from August 2009 to February 2011, neonates with suspected brain injury in NICU, Department of Pediatrics affiliated to Fudan University, were enrolled in the study. Routine MRI and SWI scans were performed at the same time. The patients were divided into term group and premature group. The location of hemorrhage, the number of hemorrhage focus and the area of hemorrhage were measured by conventional MRI and SWI. Results in 596 neonates with suspected brain injury, 117 cases (19.6%) were detected intracranial hemorrhage by conventional MRI, 134 cases (22.5%) were detected by SWI in premature infants group, 81 cases (60.4%) in premature infants group, including 40 cases (33 premature infants) with germinal stroma hemorrhage. There were 7 term infants, 68 cases of lateral ventricular hemorrhage (54 premature infants, 14 term infants), 30 choroidal plexus hemorrhage (18 premature infants), 12 cases of term infants, 6 cases of third ventricle hemorrhage (premature infants), 3 cases of cerebral aqueduct hemorrhage (premature infants), 27 cases of fourth ventricle hemorrhage (23 cases of premature infants, 4 cases of term infants), 22 cases of hemorrhage of cerebral parenchyma (14 cases of premature infants, 14 cases of premature infants), 27 cases (23 cases of premature infants, 4 cases of term infants), 22 cases of hemorrhage of cerebral parenchyma (14 cases of premature infants). There were 8 term infants, 20 cases of cerebellar hemorrhage (11 premature, 9 term), 1 brain stem hemorrhage (full-term), 10 subarachnoid hemorrhage (4 preterm, 6 term), 36 subdural hemorrhage (17 premature). Of the 19 term infants, 2 (term) .2 germinal stroma intraventricular hemorrhage (6 sites), except for mesencephalic aqueduct hemorrhage, 2 cases (term infants), 2 cases (term infants) .2 germinal stroma intraventricular hemorrhage (6 parts), except the mesencephalic aqueduct hemorrhage, The number of lesions detected by SWI was higher than that of conventional MRI (P 0.05). SWI was higher in subarachnoid hemorrhage than in conventional MRI (P0.05), but there was no significant difference between SWI and MRI in the detection of subdural hemorrhage and epidural hemorrhage. (P 0.05) .3SWI sequence 81 cases of premature infants suffered from germinal stroma hemorrhage (44 cases), lateral ventricular hemorrhage (90 cases) and choroid plexus hemorrhage (26 cases). Choroidal plexus hemorrhage (18 cases) was frequently seen in. 498 cases with both SWI and conventional Mr imaging. The area of intracranial hemorrhage (germinal stroma-intraventricular hemorrhage, cerebral and cerebellar parenchyma hemorrhage) was larger than that of conventional MRI T2WI sequence (0.69 卤0.63) vs (0.49 卤0.48) (P 0.001). Conclusion compared with conventional MRI, SWI has obvious advantages in detecting various types of intracranial hemorrhage and subarachnoid hemorrhage in neonates, the number of lesions and the area of hemorrhage, which can be used as an effective supplement to conventional MRI.
【作者单位】：复旦大学附属儿科医院放射科;上海市儿童医院;上海交通大学附属儿童医院放射科;复旦大学附属儿科医院新生儿科;复旦大学附属华山医院放射科;上海市静安区中心医院放射科;
【分类号】：R722.151;R445.2

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