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目的采用磁共振成像(MRI)和磁共振波谱(1HMRS)对新生儿缺氧缺血性脑病(HIE)预后进行早期诊断,探讨其临床诊断价值及预后评估。方法选取2012年1月-2015年1月于该院确诊的足月HIE新生儿50例,将其作为HIE组,另选取足月无窒息史的新生儿50例作为对照组,对其临床资料进行回顾性分析,分别采用MRI与1HMRS对新生儿HIE预后进行早期诊断,以探讨其临床诊断价值及预后评估。结果经头颅MRI检查,HIE组新生儿出现6种早期异常现象,分别为皮层TIWI高信号、弥漫性脑颅出血、幕上脑水肿均数/叶数、蛛网膜下腔出血、白质TIWI高信号、双基底节区高信号伴随内囊后肢高信号消失,MRI均能较为清晰地显示;HIE组与对照组基底节兴趣区及额叶兴趣区胆碱复合物(Cho)/肌酸(Cr)、Cho/N-乙酰天门冬氨酶(NAA)及NAA/Cho比值进行比较,差异均具有统计学意义(t值分别为3.673、4.056、4.168;3.515、4.142、4.948,均P<0.05)。结论 MRI与1HMRS均能够对新生儿HIE预后进行很好的早期评估,能够客观反映足月新生儿HIE的脑代谢变化,有助于早期诊断新生儿HIE。
Objective To evaluate the prognosis of neonatal hypoxic-ischemic encephalopathy (HIE) by MRI and 1HMRS, and to evaluate its clinical value and prognosis. Methods Fifty term neonates with full-term HIE diagnosed in our hospital from January 2012 to January 2015 were selected as HIE group. Another 50 neonates with no history of asphyxia were enrolled in this study. The clinical data We retrospectively analyzed the early diagnosis of neonatal HIE prognosis by using MRI and 1HMRS, respectively, to explore the clinical diagnostic value and prognosis. Results There were six early abnormalities in the neonates of HIE group, which were high TIES signal, diffuse cerebral hemorrhage, supratentorial brain edema / leaf number, subarachnoid hemorrhage and white matter TIWI high signal , High signal of double basal ganglia disappeared with the high signal of hindlimb in the internal capsule, and MRI can be shown more clearly. In HIE group and control group, basal ganglia interest area and frontal lobe area of interest cholinergic complex (Cho) / creatine (Cr) , Cho / N-acetyl-asparaginase (NAA) and NAA / Cho ratios (t = 3.673,4.056,4.168; 3.515,4.142,4.948, respectively, P <0.05). Conclusion Both MRI and 1HMRS can make a good early assessment of neonatal HIE prognosis and objectively reflect the cerebral metabolic changes of full-term neonates with HIE, which is helpful for the early diagnosis of neonatal HIE.