MRI与~1H-MRS检查在新生儿HIE病情评估中的应用

发布时间：2018-03-10 04:33

本文选题：新生儿缺氧缺血性脑病　切入点：磁共振成像　出处：《山东医药》2017年37期 　论文类型：期刊论文

【摘要】：目的探讨磁共振成像(MRI)与~1H磁共振波谱(~1H-MRS)联合检查对新生儿HIE病情严重程度的评估价值。方法选取HIE患儿43例,根据临床分度标准将其分为轻度组(n=23)、中度组(n=11)和重度组(n=9);同期选取健康新生儿50例作为对照组。各组均于出生2~7 d行MRI和~1H-MRS检查。MRI采用T1W1-SE、TSET2W及FLAIR序列进行检测,~1H-MRS采用PRESS序列测定脑部代谢化合物N-乙酰天门冬氨酸(NAA)、胆碱(Cho)、肌醇(MI)、乳酸(Lac)、谷氨酰胺(Clu)、谷氨酸(Gln),计算脑部代谢化合物与肌酸(Cr)的比值。结果MRI检查诊断符合率对照组为100%、轻度组为52.17%、中度组为72.73%、重度组为77.78%;中、重度组诊断符合率高于轻度组(P均0.05),中、重度组比较差异无统计学意义(P0.05)。轻度组、中度组、重度组NAA/Cr低于对照组(P均0.05),Lac/Cr、(Clu+Gln)/Cr高于对照组(P均0.05),且患儿病情越重以上指标变化越明显。结论 MRI可检测HIE患儿尤其中重度患儿的病灶范围和数目,~1H-MRS可无创测量HIE患儿脑组织产生的异常中间代谢物。二者联合检测可提高HIE的确诊率,确定患儿脑组织损伤程度。
[Abstract]:Objective to evaluate the value of magnetic resonance imaging (MRI) combined with 1H-MRS in evaluating the severity of neonatal HIE. According to the clinical grading criteria, it was divided into mild group (n = 23), moderate group (n = 11) and severe group (n = 50). 50 healthy newborns were selected as control group. MRI and 1H-MRS examination were performed on the 7th day of birth. MRI was detected by T1W1-SETSET2W and FLAIR sequence. The PRESS sequence was used to determine the metabolic compounds N-acetylaspartate, cholinergic, inositol, lactic acid, glutamine and glutamate. The ratio of brain metabolites to creatine (Cr) was calculated. Results the diagnostic rate of MRI was consistent with that of the control group. 52.17 in the mild group, 72.73 in the moderate group, 77.78 in the severe group; The diagnostic coincidence rate in the severe group was higher than that in the mild group (P < 0.05), but there was no significant difference between the severe group and the moderate group (P 0.05). The NAA/Cr of the severe group was lower than that of the control group (P < 0.05). The higher the severity of the disease, the more obvious the changes of the above indexes were. Conclusion MRI can detect the extent and number of lesions in the HIE patients, especially in the moderate and severe children. 1H-MRS can be used to measure HIE noninvasively. The abnormal intermediate metabolites produced by brain tissue of children can improve the diagnosis rate of HIE by combined detection of the two metabolites. The degree of brain injury was determined.
【作者单位】：哈励逊国际和平医院;
【基金】：河北省指令性课题计划(ZL20140001)
【分类号】：R742

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