CAJ | 학술논문

目的：通过分析磁共振弥散张量成像(DTI)联合1H磁共振波谱(1H-MRS)应用于新生儿缺氧缺血性脑病(HIE)中诊断效果，从而为临床HIE患者准确诊断提供参考。方法选取本院90例HIE患儿作为本次研究观察组，另选取同期正常分娩的90例健康新生儿为研究对照组。两组均采用1H-MRS及DTI扫描检查，并比较两组影像学图像，测定两组胆碱复合物(Cho)、N-乙酰基天门冬氨酸(NAA)、肌酸复合物(Cr)、乳酸(LAC)、肌醇(MI)、谷氨酸及谷氨酰胺(Glu-Gln)等代谢产物，然后进行比较。结果经检查发现，其中对照组未见DTI异常信号；观察组中，采用DTI检出HIE者为76例，诊断准确率为84.4%明显高于普通MRI检出39例，占43.3%，具有统计学意义，P<0.05。观察组患儿NAA/Cr明显低于对照组，而Cho/Cr、MI/Cr及Clu+Cln/Cr、Lac/Cr明显高于对照组，差异具有显著性，P<0.05。结论临床应用DTI可于HIE早期检测中有效显示其病灶范围及数目，同时采用1H-MRS可无创地测量患儿脑部组织缺氧、缺血过程中所产生的代谢产物，两者结合可提高患儿临床诊断准确性，为患者预后评估提供有力价值。
목적：통과분석자공진미산장량성상(DTI)연합1H자공진파보(1H-MRS)응용우신생인결양결혈성뇌병(HIE)중진단효과，종이위림상HIE환자준학진단제공삼고。방법선취본원90례HIE환인작위본차연구관찰조，령선취동기정상분면적90례건강신생인위연구대조조。량조균채용1H-MRS급DTI소묘검사，병비교량조영상학도상，측정량조담감복합물(Cho)、N-을선기천문동안산(NAA)、기산복합물(Cr)、유산(LAC)、기순(MI)、곡안산급곡안선알(Glu-Gln)등대사산물，연후진행비교。결과경검사발현，기중대조조미견DTI이상신호；관찰조중，채용DTI검출HIE자위76례，진단준학솔위84.4%명현고우보통MRI검출39례，점43.3%，구유통계학의의，P<0.05。관찰조환인NAA/Cr명현저우대조조，이Cho/Cr、MI/Cr급Clu+Cln/Cr、Lac/Cr명현고우대조조，차이구유현저성，P<0.05。결론림상응용DTI가우HIE조기검측중유효현시기병조범위급수목，동시채용1H-MRS가무창지측량환인뇌부조직결양、결혈과정중소산생적대사산물，량자결합가제고환인림상진단준학성，위환자예후평고제공유력개치。
Objective Through the analysis of diffusion tensor imaging (DTI) combined 1H magnetic resonance spectroscopy (1H-MRS) in neonatal hypoxic-ischemic encephalopathy (HIE) in the diagnostic results, thus providing an accurate reference for clinical diagnosis in patients with HIE.Methods Select the hospital 90 cases of HIE, as observed in this study group, select another period of 90 cases of normal deliveries healthy newborns in the control group for the study. Both groups were1H-MRS and DTI scans and radiographic images were compared, measured two choline (Cho), N-acetyl aspartate (NAA), creatine (Cr), lactate (LAC), myo-inositol (MI), glutamate and glutamine (Glu-Gln) and other metabolites, and then compared.Results The inspection found that one of the control group had no abnormal signal DTI; observation group, using DTI HIE were detected for 76 cases, 84.4% diagnostic accuracy was significantly higher than normal MRI detected in 39 cases (43.3%), a statistically significance, P<0.05. Observation group of children NAA/Cr was significantly lower than the control group, while Cho/Cr, MI/Cr and Clu+Cln/Cr, Lac/Cr was significantly higher, the difference was significant, P<0.05. Conclusion DTI may HIE clinical applications for early detection and effective display of its range and the number of lesions, while using1H-MRS can noninvasively measuring brain tissue hypoxia in children, metabolites produced during ischemia, a combination that can increase the risk of children clinical diagnostic accuracy for patients to provide strong prognostic value.