CAJ | 학술논문

目的：探讨磁共振成像(magnetic resonance imaging，MRI)对新生儿脑白质弥漫性高信号(diffuse excessive high signal intensity，DEHSI)的诊断及预后评估的价值。材料与方法通过对比和随访不同类型DEHSI患儿常规MRI特征性表现、脑白质病灶演变过程及患儿神经心理发育结果，分析三者之间的内在联系。结果生后年龄、胎龄、头围与DEHSI评估之间呈显著负相关(r=－0.266、－0.303、－0.200，P均＜0.05)。DEHSI的严重程度与矫正年龄后5个月大的患儿的各项预后指标评分(ADQ、GMDQ、FMDQ、LDQ、PSDQ)呈负相关(r=－0.423、－0.499、－0.553、－0.317、－0.453，P均＜0.05)。结论宫外暴露时间可促进新生儿成熟；此外，胎龄越大，胎儿越成熟，DEHSI分级越低。MRI可区分不同分级的DEHSI及较好的评价预后，中重度DEHSI患儿预后较差，无或轻度DEHSI患儿预后较好。
목적：탐토자공진성상(magnetic resonance imaging，MRI)대신생인뇌백질미만성고신호(diffuse excessive high signal intensity，DEHSI)적진단급예후평고적개치。재료여방법통과대비화수방불동류형DEHSI환인상규MRI특정성표현、뇌백질병조연변과정급환인신경심리발육결과，분석삼자지간적내재련계。결과생후년령、태령、두위여DEHSI평고지간정현저부상관(r=－0.266、－0.303、－0.200，P균＜0.05)。DEHSI적엄중정도여교정년령후5개월대적환인적각항예후지표평분(ADQ、GMDQ、FMDQ、LDQ、PSDQ)정부상관(r=－0.423、－0.499、－0.553、－0.317、－0.453，P균＜0.05)。결론궁외폭로시간가촉진신생인성숙；차외，태령월대，태인월성숙，DEHSI분급월저。MRI가구분불동분급적DEHSI급교호적평개예후，중중도DEHSI환인예후교차，무혹경도DEHSI환인예후교호。
Objective:To explore the value of magnetic resonance imaging (MRI) in the diagnosis and prognosis of neonatal cerebral white matter diffuse excessive high signal intensity (DEHSI).Materials and Methods:To compare and analyze the typical features in MRI, the process of cerebral white matter lesions and the neurodevelopmental outcomes of neonates.Results:Postnatal age, gestational age, head girth had a signiifcantly negative correlation with DEHSI(r=-0.266,-0.303,-0.200, allP<0.05). There was a negative correlation between the grade of DEHSI and the Gesell scores (ADQ, GMDQ, FMDQ, LDQ, PSDQ) of infants at 5 month corrected age (r=-0.423,-0.499,-0.553,-0.317,-0.453, allP<0.05). Conclusion:Extrauterine exposure time could promote the degree of prematurity in infants. In addition, the long time stay in intrauterine, the higher the maturity, and the lower grade of DEHSI. MRI could distinguish the different grades of DEHSI and assess the neurodevelopmental outcomes. The neurodevelopmental outcomes was poor in moderate-sereve DEHSI of infants, which was good in infants with no or mild DEHSI.