论文部分内容阅读
目的探讨磁共振(MRI)和电子计算机断层扫描(CT)影像分度在评估足月新生儿HIE脑损伤程度中的价值。方法 35例足月HIE患儿于出生11 d内同步进行MRI及CT检查,并与临床分度进行比较。MRI主要观察和分度指标为T1WI、T2WI的异常信号灶;CT主要观察和分度指标为CT值、低密度灶、形态学情况及出血区。应用SPSS 13.0软件进行统计学分析。结果 35例足月HIE患儿MRI及CT影像分度与临床分度均有高度关连性(列联系数为0.723、0.731)。HIE以临床表现为诊断标准,CT检出率为91.4%,假阴性率为8.6%,MRI检出率为100%。26例轻度HIE患儿中,临床与影像分度符合率为46.2%(CT)、61.5%(MRI);8例中度HIE患儿中,MRI检出6例、CT检出5例。在34例轻、中度HIE患儿中,MRI示2例基底核出血,发现率为5.9%;CT示9例蛛网膜下腔出血(l例合并脑室内出血),发现率为26.5%;1例重度HIE患儿MRI及CT均示多灶性出血。结论新生儿HIE的诊断应以临床表现及临床分度为主,影像表现及分度仅作为诊断参考指征之一。MRI异常检出率较CT高,能更早检测出基底核损伤;而CT更能发现蛛网膜下腔出血。
Objective To investigate the value of magnetic resonance imaging (MRI) and computerized tomography (CT) imaging in assessing the extent of brain injury in full-term neonates with HIE. Methods Thirty-five full-term HIE children underwent synchronous MRI and CT examination within 11 days of birth, and compared with clinical index. MRI main observation and indexing were T1WI and T2WI abnormal signals. The CT observation and indexing were CT value, low-density focus, morphology and hemorrhage area. SPSS 13.0 software was used for statistical analysis. Results The MRI and CT images of 35 full-term HIE children were highly correlated with the clinical index (the coefficient of association was 0.723,0.731). HIE clinical manifestations as the diagnostic criteria, CT detection rate was 91.4%, false negative rate was 8.6%, MRI detection rate was 100%. Among 26 mild HIE children, the coincidence rate of clinical and imaging index was 46.2% (CT) and 61.5% (MRI). Among 8 moderate HIE children, MRI was detected in 6 cases and CT in 5 cases. In 34 children with mild or moderate HIE, two cases of basal ganglia hemorrhage were found by MRI with a detection rate of 5.9%. CT showed 9 cases of subarachnoid hemorrhage (1 case with intraventricular hemorrhage), with a detection rate of 26.5%. 1 Cases of severe HIE children with MRI and CT showed multifocal hemorrhage. Conclusion The diagnosis of neonatal HIE should be based on clinical manifestations and clinical sub-degree, imaging performance and indexing are only used as one of the diagnostic reference indications. MRI anomaly detection rate higher than CT, can detect basal gangular lesion earlier; and CT can find subarachnoid hemorrhage.