CAJ | 학술논문

目的：探讨扩散加权成像(DWI)和质子磁共振波谱(1H-MRS)在新生儿低血糖脑损伤中的应用价值。方法收集17例经MRI确诊的低血糖性脑损伤新生儿(病例组)的临床资料，并随机选取17例同期单纯性低血糖但MRI正常的新生儿为对照组，病例组及对照组均行常规MRI、DWI和1H-MRS扫描，记录代谢产物1H-MRS波峰下面积和表面弥散系数(ADC)值，并进行比较。结果病例组平均最低血糖值低于对照组(P<0.01)，低血糖持续时间长于对照组(P<0.01)。病例组左侧顶枕叶的乳酸/肌酸比值(Lac/Cr)较对照组升高， N乙酰天门冬氨酸/肌酸比值(NAA/Cr)较对照组降低，差异有统计学意义(P<0.05)。病例组ADC值较对照组低，差异有统计学意义(P<0.05)。结论 DWI和MRS对新生儿低血糖脑损伤的特异性、敏感性较常规MRI高，为临床诊疗提供有力依据，值得深入研究及推广。
목적：탐토확산가권성상(DWI)화질자자공진파보(1H-MRS)재신생인저혈당뇌손상중적응용개치。방법수집17례경MRI학진적저혈당성뇌손상신생인(병례조)적림상자료，병수궤선취17례동기단순성저혈당단MRI정상적신생인위대조조，병례조급대조조균행상규MRI、DWI화1H-MRS소묘，기록대사산물1H-MRS파봉하면적화표면미산계수(ADC)치，병진행비교。결과병례조평균최저혈당치저우대조조(P<0.01)，저혈당지속시간장우대조조(P<0.01)。병례조좌측정침협적유산/기산비치(Lac/Cr)교대조조승고， N을선천문동안산/기산비치(NAA/Cr)교대조조강저，차이유통계학의의(P<0.05)。병례조ADC치교대조조저，차이유통계학의의(P<0.05)。결론 DWI화MRS대신생인저혈당뇌손상적특이성、민감성교상규MRI고，위림상진료제공유력의거，치득심입연구급추엄。
Objective To investigate the value of Diffusion Weighted Imaging(DWI) and Proton Magnetic Resonance Spectroscopy (1H-MRS) in neonatal hypoglycemic encephalopathy (NHE). Methods The case group was 17 patients of NHE diagnosed by MRI and 17 hypoglycemic neonatal had no encephalopathy (Control group). Both of them received the scan including conventional MRI, DWI and 1H-MRS. Areas of metabolizing production under wave crest and apparent diffusion coefficient(ADC) values were recorded for statistical analysis. Results Compared with control group, the case group had lower mean lowest blood glucose level (P<0.01). Case group's duration of hypoglycemia was longer than control group's (P<0.01). Between control group and case group, the difference of Lac/Cr, NAA/Cr in occipital and parietal lobe was statistically significant (P<0.05). Between control group and case group, the difference of ADC values in left occipital and parietal lobe was statistically significant (P<0.05). Conclusion DWI and 1H-MRS have more specific and sensitive than conventional MRI in NHE. It can provide more powerful evidence for clinical diagnosis and treatment,and deserve to in-depth research and extension.