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目的初步探讨新生儿低血糖脑损伤的高场MRI表现。方法回顾性分析经临床确诊的23例低血糖脑损伤新生儿的临床和MRI资料,MRI序列包括常规T1WI、T2WI、DWI及FLAIR序列。6例患儿有1个月后MR复查资料。结果脑损伤早期DWI主要表现为高信号和ADC值降低,常规序列或表现正常,或表现T1WI稍低信号,T2WI稍高信号。受累脑区包括双侧顶枕叶23例,胼胝体11例,双侧基底节区9例,双侧大脑广泛受2例;6例随访,2例正常,4例顶枕叶出现软化灶。结论新生儿低血糖脑损伤多发生在顶枕叶、胼胝体和基底节,DWI早期诊断优于常规序列,常规MRI结合DWI扫描对该病的早期诊断及预后评估具有重要价值。
Objective To investigate the high-field MRI manifestations of neonatal hypoglycemic brain injury. Methods The clinical and MRI findings of 23 clinically diagnosed neonates with hypoglycemic brain injury were retrospectively analyzed. The MRI sequences included routine T1WI, T2WI, DWI and FLAIR sequences. Six patients had MR data after 1 month. Results DWI in early stage of brain injury mainly manifested the decrease of high signal and ADC value, normal sequence or normal performance, or slightly lower signal of T1WI and slightly higher signal of T2WI. Involved brain areas including bilateral top occipital lobe in 23 cases, corpus callosum in 11 cases, bilateral basal ganglia in 9 cases, bilateral brain widely accepted by 2 cases; 6 cases were followed up, 2 cases were normal, 4 cases of the top occipital lobe softening. Conclusions Hypoglycemic brain injury in neonates mostly occurs in the top occipital lobe, corpus callosum and basal ganglia. Early diagnosis of DWI is superior to conventional sequences. Conventional MRI combined with DWI scan is of great value in the early diagnosis and prognosis evaluation of the disease.