弥散加权成像对新生儿脑损伤的早期诊断价值

摘要

目的 该研究主要就新生儿脑损伤早期行弥散加权成像(DWI)的临床价值展开分析. 方法 整群选取82例该院2012年11月—2013年11月所收治的脑损伤新生儿作为研究对象,所有新生儿均经核磁共振检查弥散加权成像得以确诊, 对其临床资料进行回顾性分析. 结果 在日龄低于3 d的缺血性缺氧性脑损伤 (HIE) 患儿中有86%为DWI呈高信号,T1WI、T2WI异常信号范围较小或呈阴性; 日龄4~7 d的脑损伤患儿中有77%为DWI高信号,T1WI、T2WI异常信号范围较小或呈阴性;日龄超过7 d的患儿仅有20%呈DWI呈高信号,T1WI、T2WI信号较窄;对于低血糖脑损伤患儿,在发病3 d内对其行MRI检查,可见DWI高信号,T1WI、T2WI为阴性,发病4~7 d后,仅有75%的患儿呈DWI高信号,T1WI、T2WI阴性. 结论 在对新生儿是否存在脑损伤进行临床诊断时,MRI DWI能在一周内判断出新生儿是否存在脑损伤,相较于常规MRI T1WI、T2WI,它能够更早、更快的发现新生儿是否存在脑损伤,并确定其脑损伤类型,为新生儿的治疗奠定了基础,MRI DWI具有较高的临床应用价值,值得大力推广并普及使用.%Objective To analyze the clinical value of diffusion-weighted imaging applied in diagnosis of early neonatal brain injury. Methods A total of 82 cases of neonatal brain injury admitted to our hospital from November 2012 to Novem-ber 2013 were selected as the research object, and all the neonates were confirmed by diffusion-weighted imaging from nu-clear magnetic resonance inspection. Their clinical data was retrospectively analyzed. Results For those neonates with hy-poxic ischemic brain damage aged less than 3 days, in 86%of them DWI showed high signal, and T1WI and T2WI showed small range of abnormal signal or negative; for those with brain damage aged 4-7 days, in 77% of them DWI showed high signal, and T1WI and T2WI showed small range of abnormal signal or negative; for those aged more than 7 days, in only 20%of them the DWI showed high signal, and T1WI and T2WI showed narrow signal;for neonates with hypoglycemic brain injury , MRI check performed within 3 days after onset showed that the DWI showed high signal and that T1WI and T2WI were negative, but 4-7 days after onset, in only 75%of them DWI showed high signal, and T1WI and T2WI were negative. Conclusion In the clinical diagnosis of neonates to determine whether they were with brain damage, MRI and DWI can bring good effect, and compared with conventional MRI, T1WI and T2WI, it can not only determine early and timely whether they are with brain damage, but also lay a foundation for their treatment. Therefore MRI and DWI are of higher clinical application value, and worthy of promotion.