DWI扫描联合常规MRI序列检查在新生儿HIE诊断中的临床意义

doi:10.3760/cma.j.issn.1007-1245.2024.12.018

国际医药卫生导报 ›› 2024, Vol. 30 ›› Issue (12): 2025-2029.DOI: 10.3760/cma.j.issn.1007-1245.2024.12.018

DWI扫描联合常规MRI序列检查在新生儿HIE诊断中的临床意义

冀笑笑¹ 吴霞² 贾荣荣¹

¹西北大学附属医院•西安市第三医院医学影像科，西安　710018；²西北大学附属医院•西安市第三医院新生儿科，西安　710018

收稿日期:2023-12-25 出版日期:2024-06-15 发布日期:2024-06-26
通讯作者: 吴霞，Email：changshifeng223@163.com
基金资助:
陕西省重点研发计划（2018SF-122）

Clinical significance of DWI scanning combined with conventional MRI sequence examination in the diagnosis of neonatal hypoxic-ischemic encephalopathy

Ji Xiaoxiao¹, Wu Xia², Jia Rongrong¹

¹Department of Medical Imaging, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an 710018, China; ²Department of Neonatology, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an 710018, China

Received:2023-12-25 Online:2024-06-15 Published:2024-06-26
Contact: Wu Xia, Email: changshifeng223@163.com
Supported by:
Key Research and Development Plan of Shaanxi Province (2018SF-122)

摘要/Abstract

摘要：

目的　探究弥散加权成像（DWI）扫描联合常规磁共振成像（MRI）序列检查在新生儿缺氧缺血性脑病（HIE）诊断中的临床意义。方法　选取2020年1月至2023年10月于西北大学附属医院•西安市第三医院就诊的85例新生儿HIE作为HIE组，同期选取85例健康新生儿作为对照组。HIE组男48例，女37例；胎龄38～40（39.23±0.65）周；出生体重2.21～4.13（3.24±0.41）kg。对照组男43例，女42例；胎龄37～41（39.03±0.84）周；出生体重2.19～4.06（3.11±0.45）kg。分析HIE组DWI扫描联合常规MRI序列检查结果；比较两组DWI参数［丘脑、半卵圆中心、顶叶白质、豆状核、内囊后肢区域脑组织表观扩散系数（ADC）值］；分析常规MRI各序列病变检出结果；通过比较DWI扫描、常规MRI序列检查及联合诊断结果，分析其诊断效能。采用独立样本t检验和χ²检验。结果　HIE组丘脑［（0.84±0.05）mm²/s］、半卵圆中心［（1.04±0.12）mm²/s］、顶叶白质［（1.14±0.04）mm²/s］、豆状核［（0.76±0.04）mm²/s］、内囊后肢［（0.73±0.03）mm²/s］区域脑组织ADC值均低于对照组［（1.16±0.08）mm²/s、（1.83±0.17）mm²/s、（1.68±0.16）mm²/s、（1.23±0.09）mm²/s、（1.26±0.10）mm²/s］（均P<0.05）；DWI扫描联合常规MRI序列检查诊断的灵敏度为97.65%（83/85），高于DWI扫描和常规MRI序列检查；漏诊率为2.35%（2/85），低于DWI扫描和常规MRI序列检查（均P<0.05）。结论　DWI扫描联合常规MRI序列检查在新生儿HIE诊断中具有较高的诊断灵敏度，漏诊率较低，可为临床诊断HIE提供可靠依据。

关键词:

弥散加权成像, 磁共振成像, 联合诊断, 新生儿缺氧缺血性脑病, 临床意义

Abstract:

Objective　To explore the clinical significance of diffusion-weighted imaging (DWI) scanning combined with conventional magnetic resonance imaging (MRI) sequence examination in the diagnosis of neonatal hypoxic-ischemic encephalopathy (HIE). Methods　A total of 85 newborns with HIE who visited the Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, from January 2020 to October 2023 were selected as the HIE group, and 85 healthy newborns were selected as the control group during the same period. There were 48 boys and 37 girls in the HIE group, with gestational age of 38-40 (39.23±0.65) weeks and birth weight of 2.21-4.13 (3.24±0.41) kg. There were 43 boys and 42 girls in the control group, with gestational age of 37-41 (39.03±0.84) weeks and birth weight of 2.19-4.06 (3.11±0.45) kg. The results of DWI scanning combined with conventional MRI sequence examination in the HIE group were analyzed, and the DWI parameters [the values of apparent diffusion coefficient (ADC) of brain tissue in the thalamus, centrum ovale majus, parietal white matter, lenticular nucleus, and posterior limb of the internal capsule] of the two groups were compared. The results of lesion detection in each sequence of conventional MRI were analyzed. The diagnostic efficacy of DWI scanning, conventional MRI sequence alone and in combination were compared. Independent sample t test and χ² test were used. Results　The ADC values of brain tissue in the thalamus [(0.84±0.05) mm²/s], centrum ovale majus [(1.04±0.12) mm²/s], parietal white matter [(1.14±0.04) mm²/s], lenticular nucleus [(0.76±0.04) mm²/s], and posterior limb of the internal capsule [(0.73±0.03) mm²/s] in the HIE group were lower than those in the control group [(1.16±0.08) mm²/s, (1.83±0.17) mm²/s, (1.68±0.16) mm²/s, (1.23±0.09) mm²/s, and (1.26±0.10) mm²/s] (all P<0.05). The diagnostic sensitivity of DWI scanning combined with conventional MRI sequence examination was 97.65% (83/85), which was higher than those of DWI scanning and conventional MRI sequence examination alone, and the missed diagnosis rate was 2.35% (2/85), which was lower than those of DWI scanning and conventional MRI sequence examination alone (all P<0.05). Conclusion　The combination of DWI scanning and conventional MRI sequence examination has a high sensitivity in the diagnosis of neonatal HIE and a low missed diagnosis rate, which can provide reliable basis for clinical diagnosis of HIE.

Key words:

Diffusion weighted imaging, Magnetic resonance imaging, Combined diagnosis, Neonatal hypoxic-ischemic encephalopathy, Clinical significance

冀笑笑吴霞贾荣荣.

DWI扫描联合常规MRI序列检查在新生儿HIE诊断中的临床意义 [J]. 国际医药卫生导报, 2024, 30(12): 2025-2029.

Ji Xiaoxiao, Wu Xia, Jia Rongrong.

Clinical significance of DWI scanning combined with conventional MRI sequence examination in the diagnosis of neonatal hypoxic-ischemic encephalopathy [J]. International Medicine and Health Guidance News, 2024, 30(12): 2025-2029.

参考文献

[1] 田鹏,张沥文,杨莎.缺氧缺血性脑病新生儿血清CK-MB、cTnI水平与NABA评分的相关性[J].中国计划生育学杂志,2022,30(12):2852-2855.DOI:10.3969/j.issn.1004-8189. 2022.12.039.
[2] 莫韦宽,刘小兰,徐梅.颅脑超声联合相关血清指标诊断新生儿缺血缺氧性脑病价值[J].中国计划生育学杂志,2023,31(4):936-939,994.DOI:10.3969/j.issn.1004-8189.2023. 04.039.
[3] 杨昭君,朱法荣.亚低温联合促红细胞生成素检测对缺氧缺血性脑病新生儿血清炎性因子和脑组织损伤标志物的影响[J].中西医结合心脑血管病杂志,2020,18(7):1168-1170.DOI:10.12102/j.issn.1672-1349.2020.07.036.
[4] 雷玉琳,冯琴,熊伶俐,等.新生儿缺血缺氧性脑病患儿cTnI、CK-MB、IL-6及hs-CRP表达水平及意义[J].西部医学,2023,35(5):745-749.
[5] Zhang X, Peng KZ, Xu SL, et al. The GluN2B-containing NMDA receptor alleviates neuronal apoptosis in neonatal hypoxic-ischemic encephalopathy by activating PI3K-Akt-CREB signaling pathway[J]. Physiol Res, 2023, 72(5):669-680. DOI: 10.33549/physiolres.935044.
[6] 朱彪.磁共振检查联合血清指标对新生儿缺氧缺血性脑病筛查的作用[J].吉林医学,2021,42(5):1221-1222.DOI:10.3969/j.issn.1004-0412.2021.05.082.
[7] 李元歌,陈武标,陈东,等.3D-ASL联合DWI对足月新生儿缺血缺氧性脑病的临床诊断价值[J].中国CT和MRI杂志,2021,19(9):1-3,9.DOI:10.3969/j.issn.1672-5131.2021. 09.001.
[8] 肖昕,王冬菊.新生儿缺氧缺血性脑病国内外诊断标准的比较[J].实用儿科临床杂志,2006,21(2):127-128.DOI:10.3760/cma.j.issn.2095-428X.2006.02.138.
[9] 丁丽丽,王军.盐酸纳美芬联合鼠神经生长因子对新生儿缺血缺氧性脑病的效果及对其脑电图背景活动和预后的影响[J].河北医学,2020,26(1):97-101.DOI:10.3969/j.issn.1006-6233.2020.01.023.
[10] Labusek N, Ghari P, Mouloud Y, et al. Hypothermia combined with extracellular vesicles from clonally expanded immortalized mesenchymal stromal cells improves neurodevelopmental impairment in neonatal hypoxic-ischemic brain injury[J]. J Neuroinflammation, 2023, 20(1):280. DOI: 10.1186/s12974-023-02961-0.
[11] 盛杰鑫,王萌,黄光建,等.新生儿缺血缺氧性脑病应用双源CT与MRI检查及临床分析[J].中国CT和MRI杂志,2020,18(7):16-18.DOI:10.3969/j.issn.1672-5131.2020.07.006.
[12] 宋奕,肖蕾萍,张嘉玲.血清sLOX-1、VILIP-1和脑红蛋白在新生儿缺氧缺血性脑病病情和预后判断中的价值[J].检验医学与临床,2023,20(1):67-71.DOI:10.3969/j.issn.1672- 9455.2023.01.016.
[13] 贺铮,赵燕,杨阳,等.振幅整合脑电图联合脐血血气分析对缺氧缺血性脑病新生儿预后的预测价值[J].临床误诊误治,2022,35(4):79-82.DOI:10.3969/j.issn.1002-3429.2022. 04.018.
[14] 席艳丽,张晓军,王瑞珠,等.常规磁共振及磁共振波谱成像评估新生儿缺氧缺血性脑病严重程度[J].临床放射学杂志,2021,40(8):1577-1582.DOI:10.13437/j.cnki.jcr.2021. 08.028.
[15] 段大兵,郭晓强.小儿头颈部横纹肌肉瘤的CT及MRI影像学表现[J].国际医药卫生导报,2020,26(2):210-212.DOI:10.3760/cma.j.issn.1007-1245.2020.02.018.
[16] 郑欣.常规MRI和DWI技术对新生儿缺氧缺血性脑病的诊断价值[J].影像研究与医学应用,2023,7(3):101-103.DOI:10.3969/j.issn.2096-3807.2023.03.032.
[17] 聂春霞.MRI在新生儿缺氧缺血性脑病临床诊断及预后评估中的应用观察[J].中国CT和MRI杂志,2021,19(4):8-9,42.DOI:10.3969/j.issn.1672-5131.2021.04.003.
[18] 潘泉,陈文嘉,周建立,等.彩色多普勒超声和核磁共振弥散加权成像在新生儿缺氧缺血性脑病诊断中的价值及意义[J].社区医学杂志,2022,20(10):543-546,551.DOI:10.19790/j.cnki.JCM.2022.10.03.
[19] 吴继志,武林,顾维.不同MRI技术在诊断新生儿HIE中的应用研究[J].湖南师范大学学报(医学版),2017,14(6):57-60.DOI:10.3969/j.issn.1673-016X.2017.06.017.
[20] 张莎莎.磁共振常规扫描、弥散加权像及磁敏感加权像对足月新生儿缺氧缺血性脑病的诊断价值[D].贵州:贵阳医学院,2012.

DWI扫描联合常规MRI序列检查在新生儿HIE诊断中的临床意义

Clinical significance of DWI scanning combined with conventional MRI sequence examination in the diagnosis of neonatal hypoxic-ischemic encephalopathy

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