CAJ | 학술논문

目的探讨磁敏感加权成像(SWI)在新生儿脑的斑点状白质病变(PWML)的应用价值和限度.方法对2008年8月至2010年4月34例行磁共振成像(MRI)检查显示PWML(新生儿大脑白质区T1WI高信号,T2WI等或低信号的斑点状病变)的新生儿(男21例、女13例,日龄2～17 d,平均9.24 d),进行常规MRI(包括T1WI、T2WI、Flair)、DWI和SWI检查.根据T2WI上信号特征将PWML病变分为两组:第1组T1WI高信号T2WI呈等信号;第2组T1WI高信号,T2WI呈低信号.分别观察两组PWML在SWI上的表现.结果两组共34例PWML,其中仅5例(14.7%)在SWI可见斑点状低信号出血.第1组共7例,仅1例SWI示相应PWML区域显示出血;第2组共27例,其中23例SWI上相应PWML区域未显示出血,仅4例SWI示相应PWML区域显示出血.结论 SWI能帮助鉴别新生儿颅脑T1高信号而T2等或低信号的PWML内是否存在出血,新生儿大部分PWML在SWI上显示无出血.
목적 탐토자민감가권성상(SWI)재신생인뇌적반점상백질병변(PWML)적응용개치화한도.방법 대2008년8월지2010년4월34례행자공진성상(MRI)검사현시PWML(신생인대뇌백질구T1WI고신호,T2WI등혹저신호적반점상병변)적신생인(남21례、녀13례,일령2～17 d,평균9.24 d),진행상규MRI(포괄T1WI、T2WI、Flair)、DWI화SWI검사.근거T2WI상신호특정장PWML병변분위량조:제1조T1WI고신호T2WI정등신호;제2조T1WI고신호,T2WI정저신호.분별관찰량조PWML재SWI상적표현.결과 량조공34례PWML,기중부5례(14.7%)재SWI가견반점상저신호출혈.제1조공7례,부1례SWI시상응PWML구역현시출혈;제2조공27례,기중23례SWI상상응PWML구역미현시출혈,부4례SWI시상응PWML구역현시출혈.결론 SWI능방조감별신생인로뇌T1고신호이T2등혹저신호적PWML내시부존재출혈,신생인대부분PWML재SWI상현시무출혈.
Objective To evaluate the severity of punctate white matter lesions (PWML) in neonatal brain injury with susceptibility weighted imaging (SWI) and explore the value and limitation of SWI versus the conventional magnetic resonance imaging (MRI).Methods A total of 34 neonates presenting with PWML at initial MRI were recruited for this prospective study. PWML were defined as punctuate lesions with T1 hyperintensity and T2 isointensity or hypointensity in white matter.There were 21 males and 13 females with a median age of 9.24 days (range:2-17 days).All MRI examinations were performed at 1.5 Tesla unit including conventional MRI (T1, T2 & Flair sequences), DWI and SWI.PWML were classified into two groups:(1) T1 hyperintensity & T2 isointensity;(2) T1 hyperintensity & T2 hypointensity.The manifestations of PWML on SWI were analyzed.Results Among all cases, only 5 cases (14.7%) demonstrated an evidence of hemorrhage on SWI.There were 7 cases in Group 1. Only 1 case showed punctate hypointensity in the areas of PWML on SWI while there was no hemorrhage on SWI in other 6 cases.Twenty-seven cases were in Group 2.Only 4 cases showed an evidence of hemorrhage on SWI while hemorrhage was absent on SWI in other 23 cases.Conclusion Most areas of PWML in neonatal brain show no hemorrhage on SWI.And SWI can help to identify whether or not hemorrhage is present in PWML of neonates.