| 孟琳琳,王茜,王芳,李宜芳,马祥兴,李文,王青.3.0TMR动脉自旋标记及扩散加权成像在足月新生儿缺氧缺血性脑病中的应用[J].中国医学影像技术,2015,31(4):518~521 |
| 3.0TMR动脉自旋标记及扩散加权成像在足月新生儿缺氧缺血性脑病中的应用 |
| Application of 3.0T MR arterial spin labeling and diffusion weighted imaging in full-term neonatal hypoxic ischemic encephalopathy |
| 投稿时间：2014-09-25 修订日期：2015-02-10 |
| DOI：10.13929/j.1003-3289.2015.04.009 |
| 中文关键词: 缺氧缺血,脑 弥散磁共振成像 灌注成像 |
| 英文关键词:Hypoxia-ischemia, brain Diffusion magnetic resonance imaging Perfusion imaging |
| 基金项目:济南市科技计划高校院所自主创新项目(201202225)。 |
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| 中文摘要: |
| 目的 探讨动脉自旋标记(ASL)灌注加权成像及DWI在评价新生儿缺氧缺血性脑病(HIE)中的应用价值。方法 对临床诊断为HIE的56例足月新生儿(HIE组)行常规MR(T1WI、T2WI、T2 FLAIR)及ASL、DWI,并以10例无HIE病史的轻度高胆红素血症足月新生儿为对照组。以临床诊断结果作为诊断金标准计算敏感度及特异度。选择双侧基底核区(尾状核头、豆状核)、丘脑、额叶白质(侧脑室上缘水平)为ROI,测量两组rCBF及ADC值,并分析两组各ROI的rCBF及ADC值的差异,并分析各ROI rCBF与ADC值的相关性。结果 常规MRI序列检测HIE的敏感度41.38%(12/29)、特异度55.56%(15/27);DWI序列的敏感度及特异度为50.00%(12/24)、46.88%(15/32);ASL检测HIE的敏感度及特异度为34.48%(10/29)、92.59%(25/27)。HIE组丘脑及豆状核rCBF较对照组明显升高(t=2.93、2.74,P=0.004、0.010),尾状核头部与额叶白质的rCBF较对照组差异无统计学意义。HIE组丘脑、额叶白质及豆状核ADC值较对照组减低(t=2.44、2.39、2.25,P=0.025、0.030、0.040)。丘脑和豆状核的rCBF与ADC值呈负相关(r=-0.355,P<0.01,r=-0.471,P=0.02)。结论 HIE时丘脑及豆状核血流量代偿性增加,局部脑组织水分子弥散受限。ASL及DWI技术联合应用有助于反映足月新生儿HIE的病理过程。 |
| 英文摘要: |
| Objective To evaluate the value of arterial spin labeling (ASL) and DWI in diagnosis of full-term neonatal hypoxic ischemic encephalopathy (HIE). Methods ASL, DWI and conventional MRI (T1WI, T2WI, T2 FLAIR) were performed in 56 full-term HIE neonates (HIE group) and 10 mild hyperbilirubinemia neonates without HIE (control group). The results of clinical diagnosis were selected as a diagnostic gold standard to calculate sensitivity and specificity. ROIs were selected at bilateral basal ganglia, thalamus, and frontal white matter, the relative cerebral blood flow (rCBF) and ADC were measured. The differences of rCBF values in each ROI of two groups were analyzed, as well as ADC values. The correlation of rCBF and ADC values in different ROIs were evaluated. Results The sensitivity of conventional MRI, DWI, and ASL in the diagnosis of HIE were 41.38% (12/29), 50.00% (12/24), and 34.48% (10/29), respectively, and the specificity was 55.56% (15/27),46.88% (15/32), and 92.59% (25/27), respectively. In HIE group, the rCBF values were significantly higher than those in control group at thalamus and lenticular nucleus (t=2.93, 2.74, P=0.004, 0.010), while no significant changes in the caudate nucleus head and frontal white matter. The ADC values at thalamus, frontal white matter, and lenticular nucleus of HIE group were significantly lower than control group (t=2.44, 2.39, 2.25, P=0.025, 0.030, 0.040). The rCBF and ADC values in both thalamus and lenticular nucleus were negatively correlated (r=-0.355, P<0.01; r=-0.471, P=0.02). Conclusion The blood flow of thalamus and lentiform nucleus compensatory increase in HIE, water molecules diffusion is limited in regional brain tissue. Combined application of ASL and DWI is helpful to reflect the pathological process of HIE in full-term neonates. |
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