中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2014年
4期
220-224
,共5页
磁共振成像%脑室周围白质软化%弥漫性脑白质损伤%局灶性脑白质损伤%早产儿
磁共振成像%腦室週圍白質軟化%瀰漫性腦白質損傷%跼竈性腦白質損傷%早產兒
자공진성상%뇌실주위백질연화%미만성뇌백질손상%국조성뇌백질손상%조산인
Magnetic resonance imaging%Periventricular leucomalacia%Diffuse white matter damage%Punctate white matter damage%Premature
目的 探讨最终发展为脑室周围白质软化(periventricular leucomalacia,PVL)的早产儿出生早期头部MRI表现及其演变.方法 选取2010年1月至2013年12月中国医科大学附属盛京医院新生儿科住院经MRI确诊为PVL的患儿12例,所有病例均在生后2～7d(平均5.5d)及17～23 d(平均20.3 d)完成2次常规MRI及弥散加权成像(diffusion-weighted imaging,DWI)扫描.结果 最终被确诊的12例PVL患儿,初次扫描结果:全部病例DWI显示脑室周围白质高信号,其中6例弥漫、对称性高信号,3例线状高信号,3例簇状高信号,而常规MRI仅有5例显示T1加权像稍高信号,T2加权像稍低信号,余7例无改变;再次扫描结果:全部患儿脑室周围白质出现大小不等、数量不一的病灶,常规MRI显示T1加权像低信号,T2加权像高信号,相应病变部位DWI呈低信号.结论 早产儿出生早期,DWI对发现和预测PVL优于常规MRI;弥漫性脑白质损伤易发展为PVL,较严重的局灶性脑白质损伤,如多簇状、线状损伤也有发展成PVL的可能.
目的 探討最終髮展為腦室週圍白質軟化(periventricular leucomalacia,PVL)的早產兒齣生早期頭部MRI錶現及其縯變.方法 選取2010年1月至2013年12月中國醫科大學附屬盛京醫院新生兒科住院經MRI確診為PVL的患兒12例,所有病例均在生後2～7d(平均5.5d)及17～23 d(平均20.3 d)完成2次常規MRI及瀰散加權成像(diffusion-weighted imaging,DWI)掃描.結果 最終被確診的12例PVL患兒,初次掃描結果:全部病例DWI顯示腦室週圍白質高信號,其中6例瀰漫、對稱性高信號,3例線狀高信號,3例簇狀高信號,而常規MRI僅有5例顯示T1加權像稍高信號,T2加權像稍低信號,餘7例無改變;再次掃描結果:全部患兒腦室週圍白質齣現大小不等、數量不一的病竈,常規MRI顯示T1加權像低信號,T2加權像高信號,相應病變部位DWI呈低信號.結論 早產兒齣生早期,DWI對髮現和預測PVL優于常規MRI;瀰漫性腦白質損傷易髮展為PVL,較嚴重的跼竈性腦白質損傷,如多簇狀、線狀損傷也有髮展成PVL的可能.
목적 탐토최종발전위뇌실주위백질연화(periventricular leucomalacia,PVL)적조산인출생조기두부MRI표현급기연변.방법 선취2010년1월지2013년12월중국의과대학부속성경의원신생인과주원경MRI학진위PVL적환인12례,소유병례균재생후2～7d(평균5.5d)급17～23 d(평균20.3 d)완성2차상규MRI급미산가권성상(diffusion-weighted imaging,DWI)소묘.결과 최종피학진적12례PVL환인,초차소묘결과:전부병례DWI현시뇌실주위백질고신호,기중6례미만、대칭성고신호,3례선상고신호,3례족상고신호,이상규MRI부유5례현시T1가권상초고신호,T2가권상초저신호,여7례무개변;재차소묘결과:전부환인뇌실주위백질출현대소불등、수량불일적병조,상규MRI현시T1가권상저신호,T2가권상고신호,상응병변부위DWI정저신호.결론 조산인출생조기,DWI대발현화예측PVL우우상규MRI;미만성뇌백질손상역발전위PVL,교엄중적국조성뇌백질손상,여다족상、선상손상야유발전성PVL적가능.
Objective To investigate the early MRI performance and the evolution of premature infants who developed into periventficular leucomalacia (PVL) eventually.Methods Twelve premature infants diagnosed as PVL by MRI in the department of neonatology in Shengjing Hospital of China Medical University from Jan 2010 to Dec 2013 were selected,all of the cases underwent conventional MRI and diffusion-weighted imaging (DWI) examination twice,the first examinations were finished in 2 to 7 days (mean 5.5 d) after birth and the second examinations were taken in 17 to 23 days(mean 20.3 d).Results The first examination showed:all cases performed high signal intensity of periventricular matter,including 6 diffuse and symmetrical,3 linear and 3 clustered high signal.However,only 5 of the 12 cases showed slightly high signal on T1 weighted image with low signal on T2 weighted image on conventional MRI,the other 7 cases showed no change;for the reexamination:foci of different numbers and sizes showed up in all cases,with the performance of low signal on T1 weighted image,high signal on T2 weighted image and low signal on DWI correspondingly.Conclusion DWI is superior to conventional MRI in finding and forecasting PVL;diffuse white matter damage have more probability to develop into PVL,severe local white matter damage such as multi-clustered and linear damage also can develop into PVL.
