CAJ | 학술논문

目的分析新生儿低血糖脑病的典型与非典型MRI表现.方法回顾性分析2009年7月至2013年11月温州医科大学附属第二医院20例确诊为新生儿低血糖脑病患儿的临床及MRI资料.结果 20例中,入院时18例血糖值均≤1.4 mmol/L,2例为2.1 mmol/L,其中反复低血糖者13例.临床症状表现为抽搐、反应低下、发绀及呼吸暂停.9例MRI表现典型,均有枕叶或顶叶皮质或皮层下受累,其中4例伴有胼胝体压部受累,1例伴有内囊后肢受累.11例MRI呈非典型表现,受损脑区为胼胝体压部8例,侧脑室旁白质6例,多发皮质或皮质下白质5例(枕顶叶除外),基底节区3例,半卵圆中心2例,苍白球1例,额叶局部皮质1例,桥脑1例,单侧海马1例,双侧丘脑及中脑、脑干、延髓同时受累1例.结论新生儿低血糖脑病典型MRI表现为枕顶叶皮质或皮质下受累,非典型MRI表现为除枕顶叶外其他脑区受累,常损伤多个部位.反复严重低血糖患儿易出现非典型MR表现.
목적 분석신생인저혈당뇌병적전형여비전형MRI표현.방법 회고성분석2009년7월지2013년11월온주의과대학부속제이의원20례학진위신생인저혈당뇌병환인적림상급MRI자료.결과 20례중,입원시18례혈당치균≤1.4 mmol/L,2례위2.1 mmol/L,기중반복저혈당자13례.림상증상표현위추휵、반응저하、발감급호흡잠정.9례MRI표현전형,균유침협혹정협피질혹피층하수루,기중4례반유변지체압부수루,1례반유내낭후지수루.11례MRI정비전형표현,수손뇌구위변지체압부8례,측뇌실방백질6례,다발피질혹피질하백질5례(침정협제외),기저절구3례,반란원중심2례,창백구1례,액협국부피질1례,교뇌1례,단측해마1례,쌍측구뇌급중뇌、뇌간、연수동시수루1례.결론 신생인저혈당뇌병전형MRI표현위침정협피질혹피질하수루,비전형MRI표현위제침정협외기타뇌구수루,상손상다개부위.반복엄중저혈당환인역출현비전형MR표현.
Objective To analyze the typical and non-typical magnetic resonance imaging (MRI) findings of neonatal hypoglycemia encephalopathy (NHE).Methods The clinical data and MRI findings of 20 cases with NHE were retrospectively evaluated.Results Among them,blood glucose values were ≤ 1.4 mmol/L (n =18) and 2.1 mmol/L (n =2).And 13 cases had recurrent hypoglycemia.The major clinical symptoms included convulsion,poor response,cyanosis and apnea.The typical MRI findings of abnormal signal in occipital or parietal cortex were found in 9 cases.And the involvement sites were corpus callosum (n =4) and posterior limb of internal capsule (n =1).Another 11 cases revealed non-typical MRI findings of damaged brain regions,involving splenium of corpus callosum (n =8),white matte along lateral ventricle (n =6),extensive cortical or subcortical white matter (n =5),internal capsule (n =3),centrum semiovale (n =2),globus pallidus (n =1),local cortex (frontal lobe) (n =1),pons (n =1),unilateral hippocampus (n =1) and bilateral thalamus and midbrain,brain stem and medulla oblongata (n =1).Conclusion The typical MRI findings of NHE show abnormal signal in occipital or parietal cortex.And nontypical manifestations involving multiple brain areas may be observed in cases of severe NHE.