CAJ | 학술논문

目的：应用弥散加权成像（ DWI）技术评价足月新生儿缺氧缺血性脑病（ HIE）的影像表现。方法选择2012年1～10月天津医科大学第二医院新生儿科住院的足月 HIE患儿38例，依据HIE诊断标准将患儿分为轻度HIE组（24例）和中重度HIE组（14例），另外选取12例无窒息史的足月新生儿作为对照组。对3组受试者均进行常规磁共振成像（ MRI）和 DWI检查，同时测量额顶叶灰、白质、放射冠、尾状核、豆状核、内囊后肢、丘脑等感兴趣区的表观弥散系数（ ADC ）值。结果HIE患儿在DWI检查发现深部脑白质病灶16个，基底核丘脑区病灶2个，出血性病灶1个，小脑及脑干病灶1个。感兴趣区 ADC 值组间两两比较结果显示：额叶灰质、额叶白质、顶叶灰质、顶叶白质、豆状核、丘脑及内囊后肢的ADC值在对照组与轻度HIE组间比较差异有统计学意义（P＜0．05）；各感兴趣区的ADC值在对照组与中重度HIE组间比较差异均有统计学意义（ P＜0．05）；额叶灰质、顶叶灰质、放射冠、尾状核、豆状核、丘脑及内囊后肢的ADC值在轻度HIE组与中重度HIE 组间比较差异有统计学意义（ P＜0．05）。结论 DWI在检测 HIE 深部脑白质病灶方面较敏感，通过 ADC 值测定可以对HIE脑损伤程度作出较为客观的评价。
목적：응용미산가권성상（ DWI）기술평개족월신생인결양결혈성뇌병（ HIE）적영상표현。방법선택2012년1～10월천진의과대학제이의원신생인과주원적족월 HIE환인38례，의거HIE진단표준장환인분위경도HIE조（24례）화중중도HIE조（14례），령외선취12례무질식사적족월신생인작위대조조。대3조수시자균진행상규자공진성상（ MRI）화 DWI검사，동시측량액정협회、백질、방사관、미상핵、두상핵、내낭후지、구뇌등감흥취구적표관미산계수（ ADC ）치。결과HIE환인재DWI검사발현심부뇌백질병조16개，기저핵구뇌구병조2개，출혈성병조1개，소뇌급뇌간병조1개。감흥취구 ADC 치조간량량비교결과현시：액협회질、액협백질、정협회질、정협백질、두상핵、구뇌급내낭후지적ADC치재대조조여경도HIE조간비교차이유통계학의의（P＜0．05）；각감흥취구적ADC치재대조조여중중도HIE조간비교차이균유통계학의의（ P＜0．05）；액협회질、정협회질、방사관、미상핵、두상핵、구뇌급내낭후지적ADC치재경도HIE조여중중도HIE 조간비교차이유통계학의의（ P＜0．05）。결론 DWI재검측 HIE 심부뇌백질병조방면교민감，통과 ADC 치측정가이대HIE뇌손상정도작출교위객관적평개。
Objective To explore the application of diffusion-weighted imaging ( DWI ) technology in evaluating hypoxic-ischemic encephalopathy( HIE) in full-term neonates.Methods A total of 38 full-term children with HIE admitted in the Second Hospital of Tianjin Medical University from Jan .to Oct.2012 were selected,according to the diagnostic criteria,HIE children were divided into mild HIE group(24 cases) and moderate-severe HIE group(14 cases) ,another 12 cases of full-term neonates without asphyxia history were selected as control group.Children in the 3 groups received routine magnetic resonance imaging (MRI) and DWI examination.Meanwhile,apparent diffusion coefficient(ADC) values of nine different regions of interest in the brain were measured,including frontal gray matter,frontal white matter,parietal white matter,parietal gray matter,corona radiate,caudate nucleus, lentiform nucleus,thalamus and the posterior limb of the inter-nal capsule.Results DWI examination showed 16 cases of deep white matter injury,2 cases of lesions in basal nuclei of the hypothalamus area,and 1 case of hemorrhagic lesion,1 case of cerebellum and brainstem lesion.ADC values had statistically significant differences in frontal gray matter,frontal white matter,parietal gray matter,parietal white matter,lentiform nucleus,PLIC and thalamus between mild HIE group and control group(P<0.05).ADC values had statistically significant differences in all regions of interest between mod-erate-severe HIE group and control group(P<0.05).ADC values had statistically significant differences in frontal gray matter,parietal gray matter,corona radiate,caudate nucleus, lentiform nucleus,PLIC and thala-mus between mild HIE group and moderate-severe HIE group(P<0.05).Conclusion DWI has high sen-sitivity in detecting lesions in deep white matter of HIE patients , determination of ADC value can come to objective evaluation on the degree of brain injury in HIE patients .