CAJ | 학술논문

目的探讨弥散张量(DTI)技术对缺氧缺血性脑病(HIE)患儿预后早期评估的价值.方法收集96例足月HIE患儿,进行DTI检查,依据临床诊断标准分为轻、中、重度3组,早期及后期检查时间分别为0～12 d,6～36个月,使用GE公司FunctoolⅡ软件处理DTI图像,测量胼胝体压部及内囊后肢的各向异性分数(FA)值.结果 (1)不同程度组同一部位FA值明显不同,并随时问呈线性增加,但变化的幅度不同;(2)当胼胝体压部取截断点FA≥0.437时,敏感度为83.8%,特异性为18.6%;ROC曲线下面积为0.903,95%的可信区间为0.846～0.961,标准误为0.029;当内囊后肢FA≥0.391时,敏感性为86.5%,特异性为11.9%,ROC曲线下的面积为0.940,95%的可信区间为0.896～0.984,标准误为0.022.结论磁共振DTI技术对新生儿HIE的预后评估有重要的价值.
목적 탐토미산장량(DTI)기술대결양결혈성뇌병(HIE)환인예후조기평고적개치.방법 수집96례족월HIE환인,진행DTI검사,의거림상진단표준분위경、중、중도3조,조기급후기검사시간분별위0～12 d,6～36개월,사용GE공사FunctoolⅡ연건처리DTI도상,측량변지체압부급내낭후지적각향이성분수(FA)치.결과 (1)불동정도조동일부위FA치명현불동,병수시문정선성증가,단변화적폭도불동;(2)당변지체압부취절단점FA≥0.437시,민감도위83.8%,특이성위18.6%;ROC곡선하면적위0.903,95%적가신구간위0.846～0.961,표준오위0.029;당내낭후지FA≥0.391시,민감성위86.5%,특이성위11.9%,ROC곡선하적면적위0.940,95%적가신구간위0.896～0.984,표준오위0.022.결론 자공진DTI기술대신생인HIE적예후평고유중요적개치.
Objective To study the value of diffusion tensor imaging(DTI) in early assessment of prognosis of hypoxic-ischemicencephalopathy(HIE) in new infants. Methods 96 cases of full term infants with HIE underwent DTI examinations at 0～12 days and 6～36 months. Based on clinical diagnostic criteria, 96 cases were divided into three groups: mild, moderate and severe HIE groups. Fractional anisotropy(FA) values in the corpus callosum splenium and the posterior limb of internal capsules were measured. Results (1) Varying degrees of FA groups was significantly different from the same site, increased linearly with time,but the magni-tude of change was different;(2)When FA value of corpus callosum splenium in the cut-off point was ≥0.437,the sensitivity(SE) was 83.8% , the specificity(SP) was 18.6% , ROC area under the curve was 0.903 , 95% confidence interval was from 0.846 to 0.961,standard error was 0.029;when FA value of posterior limb of internal capsule in the cut-off point ≥0.391,SE was 86.5%, SP was 11.9% ,ROC area under the curve was 0.940,95% confidence interval was from 0.898 to 0.984,standard error was 0.022. Conclusion MR DTI examination is of significant value in evaluating early the prognosis of HIE in infants.