新生儿脑梗死早期MRI表现及其在预后评估中的价值

发布时间：2019-03-27 18:30

【摘要】：目的 :探讨足月新生儿大脑中动脉(MCA)缺血性脑梗死的早期MRI表现及其在运动预后评估中的价值。方法:回顾性分析26例MRI检查确诊的足月新生儿MCA缺血性脑梗死的早期MRI资料及随访至1岁时的运动发育情况。全部病例均采用Siemens Avanto 1.5T超导型MR机行脑部常规MRI及DWI检查,6例同时行SWI检查。采用Fisher确切检验来评价MR表现与运动预后的关系。结果 :26例患儿中混合梗死12例,浅部梗死14例,常规MRI表现为MCA梗死区呈大片状稍长T1稍长T2信号,灰白质分界不清,其中6例可见皮质坏死;DWI表现为梗死区呈高信号,ADC图呈低信号,边界清晰,16例可见皮质脊髓束受累(其中混合梗死12例,浅部梗死4例),14例丘脑受累,6例胼胝体受累。混合梗死(P0.05)和皮质脊髓束受累(P0.05)高度预示偏瘫。结论 :足月新生儿MCA缺血性脑梗死早期可出现梗死区皮质坏死和累及皮质脊髓束、丘脑、胼胝体,DWI能显示梗死区的范围及受累情况,可早期评估预后。
[Abstract]:Objective: to investigate the early MRI findings of middle cerebral artery (MCA) ischemic cerebral infarction in full-term neonates and its value in the evaluation of exercise prognosis. Methods: the early MRI data and motor development of 26 full-term neonates with MCA ischemic cerebral infarction diagnosed by MRI were retrospectively analyzed. All patients were examined with Siemens Avanto 1.5T superconductive Mr machine for routine MRI and DWI examination, while 6 cases were examined by SWI at the same time. Fisher exact test was used to evaluate the relationship between MR manifestations and exercise prognosis. Results: of the 26 cases, 12 cases were mixed infarction and 14 cases were superficial infarction. Conventional MRI showed that the infarct area of MCA showed a large slice of slightly longer T1 and longer T2 signal, and the gray and white matter boundary was unclear. 6 of them showed cortical necrosis. DWI showed high signal intensity in infarction area, low signal intensity on ADC map and clear boundary. 16 cases showed cortical spinal tract involvement (12 cases of mixed infarction, 4 cases of superficial infarction), 14 cases of thalamus involvement and 6 cases of corpus callosum involvement. Mixed infarction (P0.05) and corticospinal tract involvement (P0.05) were highly predictive of hemiplegia. Conclusion: cortical necrosis and involvement of corticospinal tract, thalamus and corpus callosum can be seen in the early stage of MCA ischemic cerebral infarction in full-term neonates. DWI can show the extent and involvement of the infarct area, and can evaluate the prognosis in the early stage.
【作者单位】：湖南省儿童医院放射科;
【分类号】：R743.3;R445.2

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