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

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

Abstract

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

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

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.

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.

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