CAJ | 학술논문

目的探讨磁共振(MRI)多序列联合检查对早产儿脑损伤早期诊断的临床意义.方法回顾性分析新生儿重症监护室收治的160例早产儿的头颅MRI影像表现.结果 160例早产儿中,76例发生脑损伤,脑损伤发生率为47.5％.早产儿脑损伤以缺血性病灶多见,最常见的是脑白质损伤,尤其是脑室周围白质软化.缺血性脑损伤表现为半卵圆中心、侧脑室周围斑片状或大片状T1加权成像(T1WI)高信号、T2加权成像(T2WI)低信号,弥散加权成像(DWI)序列呈明显高信号.脑室周围白质软化MRI表现为斑片状T1WI低信号、T2WI高信号,DWI序列呈低信号.出血性损伤以脑室周围-脑室内出血多见,出血灶因出血时期不同其信号表现亦不同,急性期MRI表现为T1WI等信号或稍低信号、T2WI高信号;亚急性早期呈T1WI高信号、T2WI稍低信号,亚急性晚期呈T1WI和T2WI高信号,在磁敏感加权成像(SWI)序列上呈明显低信号.DWI对缺血灶的检出率高于常规扫描,比常规MRI能更早地显示缺血性脑损伤(x2=23.78,P＜0.05).SWI对出血灶的检出率高于常规扫描,比常规MRI能更早地显示出血性脑损伤(x2=27.02,P＜0.05).结论 MRI检查,尤其是多序列联合检查,可作为早产儿脑损伤的早期诊断提供准确的影像学依据.
목적 탐토자공진(MRI)다서렬연합검사대조산인뇌손상조기진단적림상의의.방법 회고성분석신생인중증감호실수치적160례조산인적두로MRI영상표현.결과 160례조산인중,76례발생뇌손상,뇌손상발생솔위47.5％.조산인뇌손상이결혈성병조다견,최상견적시뇌백질손상,우기시뇌실주위백질연화.결혈성뇌손상표현위반란원중심、측뇌실주위반편상혹대편상T1가권성상(T1WI)고신호、T2가권성상(T2WI)저신호,미산가권성상(DWI)서렬정명현고신호.뇌실주위백질연화MRI표현위반편상T1WI저신호、T2WI고신호,DWI서렬정저신호.출혈성손상이뇌실주위-뇌실내출혈다견,출혈조인출혈시기불동기신호표현역불동,급성기MRI표현위T1WI등신호혹초저신호、T2WI고신호;아급성조기정T1WI고신호、T2WI초저신호,아급성만기정T1WI화T2WI고신호,재자민감가권성상(SWI)서렬상정명현저신호.DWI대결혈조적검출솔고우상규소묘,비상규MRI능경조지현시결혈성뇌손상(x2=23.78,P＜0.05).SWI대출혈조적검출솔고우상규소묘,비상규MRI능경조지현시출혈성뇌손상(x2=27.02,P＜0.05).결론 MRI검사,우기시다서렬연합검사,가작위조산인뇌손상적조기진단제공준학적영상학의거.
Objective To discuss clinical significance on early diagnosis of brain injury in premature infants with multiple sequence joint inspection of magnetic resonance imaging (MRI).Methods The brain MRI findings of 160 premature infants treated by Neonatal Intensive Care Unit were analyzed retrospectively.Results In 160 premature infants,brain injury occurred in 76 cases,the incidence of brain injury was 47.5％.Ischemic lesions were seen more in brain injury in premature infants,cerebral white matter injury was the most common,especially periventricular leukomalacia.Ischemic brain injury performed patchy or large sheet increased signal intensity on T1-weighted images(T1 WI),decreased signal intensity on T2-weighted images (T2WI) and obviously increased signal intensity on diffusion weighted imaging (DWI) in half egg circle center and around the lateral ventricle.Periventricular leukomalacia performed patchy decreased signal intensity on T1WI,increased signal intensity on T2WI and decreased signal intensity on DWI.Periventricular-intraventricular hemorrhage was seen more in hemorrhagic lesions.Hemorrhage stove was performed different signal because of different bleeding time.MRI performance in acute phase was iso-signal or slightly decreased signal intensity on T1WI,increased signal intensity on T2WI,increased signal intensity on T1WI,slightly decreased signal intensity on T2WI in early subacute,increased signal intensity on T1 WI and T2WI in late subacute and obviously decreased signal intensity on magnetic sensitive weighted imaging.The detection rate of ischemic lesions by DWI was higher than the conventional MRI,and DWI could show cerebral white matter damage of premature infants much earlier than the conventional MRI.The detection rate of hemorrhage stove by susceptibility weighted imagingc (SWI) was higher than the conventional MRI (x2 =23.78,P ＜ 0.05),and SWI could show hemorrhagic lesions much earlier than conventional MRI (x2 =27.02,P ＜ 0.05).Conclusions MRI,especially combined multiple sequence checking,could provide accurate imaging evidence for the early diagnosis of brain injury in premature infants.