| 冯 蕾,刘雪成,程 伟,尤 凤,翟 建.新生儿缺血缺氧性脑病不同严重程度的MRI表现及其诊断价值分析[J].,2019,19(24):4797-4800 |
| 新生儿缺血缺氧性脑病不同严重程度的MRI表现及其诊断价值分析 |
| MRI Manifestations and Diagnostic Value of Hypoxic Ischemic Encephalopathy in Neonates with Different Severity |
| 投稿时间：2019-09-07 修订日期：2019-09-30 |
| DOI：10.13241/j.cnki.pmb.2019.24.046 |
| 中文关键词: 新生儿 缺血缺氧性脑病 磁共振 CT 诊断价值 严重程度 |
| 英文关键词: Neonatal Hypoxic ischemic encephalopathy Magnetic resonance imaging CT Diagnostic value Severity |
| 基金项目:安徽省卫生计生委科研计划项目（2016QK479） |
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| 中文摘要: |
| 摘要 目的：比较新生儿缺血缺氧性脑病（HIE）不同严重程度的磁共振（MRI）和电子计算机断层扫描（CT）下的表现，分析MRI对新生儿HIE的诊断价值。方法：选择2017年1月至2019年8月我院收治的HIE新生儿76例，其中轻度46例，中度24例，重度6例，所有患儿均接受MRI和CT检查，比较MRI与CT对新生儿HIE的诊断结果、对新生儿HIE严重程度的诊断结果及对患儿颅内病变检出率的结果。结果：以临床表现为金标准，76例患儿经MRI检查确认为新生儿HIE 的有72例，准确率为94.74%；经CT检查确认为新生儿HIE 的有63例，准确率为82.89%，MRI检查对新生儿HIE的检出率显著高于CT检查（x2=5.365，P=0.021）。MRI检查对轻度、重度HIE诊断的符合率分别为71.74%（33/46）、100.00%（6/6），显著高于CT检查的43.48%（20/46）、50.00%（3/6）（均P<0.05）；MRI与CT对中度HIE诊断的符合率分别为75.00%（18/24）、66.67%（16/24），二者比较差异无统计学意义（x2=0.403,P=0.525）。MRI检查对脑室内出血、脑室周围出血、蛛网膜下腔出血、基底节损伤、脑水肿的总体检出率为98.68%（75/76），高于CT检查的90.79%（69/76）（x2=4.750，P=0.029）。结论：与CT相比，MRI能够更清晰显示新生儿的脑组织结构，对新生儿HIE诊断和严重程度的准确率优于CT，且对新生儿HIE脑组织病变情况的诊断也较CT更佳，具有较高的诊断价值。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the Magnetic resonance imaging (MRI) and computed tomography (CT) manifestations of hypoxic ischemic encephalopathy (HIE) in different severity, and analyze the diagnostic value of MRI in HIE. Methods: 76 neonates with HIE who were admitted to our hospital from January 2017 to August 2019 were selected, including 46 mild cases, 24 moderate cases and 6 severe cases, all of whom were examined by MRI and CT, the diagnosis results of neonatal HIE by MRI and CT were compared, the diagnosis results of severity of neonatal HIE and the detection rate of intracranial lesions. Results: With clinical manifestations as the gold standard, 72 of the 76 children with neonate HIE were confirmed by MRI examination, with an accuracy rate of 94.74%. There were 63 cases confirmed as neonate HIE by CT examination, with an accuracy rate of 82.89%. The detection rate of neonate HIE by MRI was significantly higher than that by CT examination (x2=5.365, P=0.021). The coincidence rate of MRI examination for the diagnosis of mild and severe HIE were 71.74% (33/46) and 100.00% (6/6), respectively, which were significantly higher than that of CT examination 43.48% (20/46) and 50.00% (3/6) (all P<0.05). The coincidence rates of MRI and CT in the diagnosis of moderate HIE were 75.00% (18/24) and 66.67% (16/24), respectively, with no significant difference (x2=0.403, P=0.525). The overall detection rate of intraventricular hemorrhage, periventricular hemorrhage, subarachnoid hemorrhage, basal ganglia injury, and brain edema was 98.68% (75/76) on MRI, which was higher than 90.79% (69/76) on CT (x2=4.750, P=0.029). Conclusion: Compared with CT, MRI can show the brain tissue structure of the neonates more clearly, and the accuracy of diagnosis and severity of neonate HIE is better than that of CT, and the diagnosis of brain tissue lesion of neonate HIE is also better than that of CT, which has higher diagnostic value. |
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