| 邓雪琰,黄飞燕,陆笑非,杨述根,涂国建.足月缺氧缺血性脑病患儿磁共振扩散张量成像各向异性分数的动态变化及其诊断价值分析[J].,2021,(3):545-548 |
| 足月缺氧缺血性脑病患儿磁共振扩散张量成像各向异性分数的动态变化及其诊断价值分析 |
| Dynamic Changes of Anisotropic Fraction of Diffusion Tensor Magnetic Resonance Imaging in Children with Full-term Hypoxic-ischemic Encephalopathy and Its Diagnostic Value Analysis |
| 投稿时间：2020-03-27 修订日期：2020-04-24 |
| DOI：10.13241/j.cnki.pmb.2021.03.031 |
| 中文关键词: 缺氧缺血性脑病 足月 磁共振扩散张量成像 各向异性分数 诊断价值 |
| 英文关键词: Hypoxic-ischemic encephalopathy Full-term Magnetic resonance diffusion tensor imaging Anisotropic fraction Diagnostic value |
| 基金项目:四川省卫生计生委基金资助项目(160433) |
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| 摘要 目的：了解足月缺氧缺血性脑病（HIE）患儿在磁共振扩散张量成像（DTI）下各向异性分数（FA）的动态变化，分析其诊断价值。方法：选取我院从2016年2月～2019年5月收治的足月HIE患儿90例，将其按照病情严重程度的差异分成轻度HIE组45例、中度HIE组27例、重度HIE组18例，另取同期30例正常足月新生儿作为对照组。所有新生儿均进行颅脑常规磁共振成像（MRI）以及DTI扫描，测量并对比内囊前肢、内囊后肢、胼胝体膝部、胼胝体压部以及豆状核的FA值。通过ROC曲线分析各FA值的诊断效能，以Spearman相关性分析各FA值和HIE病情严重程度的相关性。结果：中度HIE组、重度HIE组内囊前肢、内囊后肢、胼胝体膝部、胼胝体压部的FA值均低于对照组，且轻度HIE组、中度HIE组患儿上述FA值高于重度HIE组（均P＜0.05）。ROC曲线分析结果显示，内囊后肢FA值对HIE的诊断效能最高，FA值的截断点为0.545，曲线下面积为0.804，其诊断敏感度、特异度以及Youden指数分别为61.4%、85.9%、0.473。Spearman相关性分析显示内囊前肢、内囊后肢、胼胝体膝部、胼胝体压部的FA值与HIE严重程度均呈负相关关系（均P＜0.05）。结论：足月HIE患儿中，中、重度HIE患儿的内囊前肢、内囊后肢、胼胝体膝部、胼胝体压部的FA值较正常足月新生儿存在明显的降低，且上述FA值与HIE病情严重程度呈负相关关系，其中内囊后肢FA值对HIE的诊断效能最高，或可作为临床诊断足月新生儿HIE的参考指标。 |
| 英文摘要: |
| ABSTRACT Objective: To understand the dynamic changes of anisotropic fraction (FA) in full-term hypoxic-ischemic encephalopathy (HIE) in children under magnetic resonance diffusion tensor imaging (DTI), and analyze its diagnostic value. Methods: 90 children with full-term HIE who were admitted to our hospital from February 2016 to May 2019 were selected, and they were divided into 45 cases in the mild HIE group, 27 cases in the moderate HIE group and 18 cases in the severe HIE group according to the difference in severity of the disease, and another 30 cases of normal full-term neonates in the same period were taken as the control group. All neonates underwent routine craniocerebral magnetic resonance imaging (MRI) and DTI scanning, and the FA values of the anterior internal capsule, posterior internal capsule, knee of corpus callosum, pressure of corpus callosum and the soya nucleus were measured and compared. The diagnostic energy efficiency of each FA value was analyzed by ROC curve, and the correlation between each FA value and the severity of HIE was analyzed by Spearman correlation. Results: The FA values of the internal capsule forelimb, internal capsule hind legs, corpus callosum at the knee, callosum pressure in the moderate HIE group and severe HIE group were all lower than those in the control group, the above FA values of children in mild HIE group, moderate HIE group were lower than those in severe HIE group(all P<0.05). Through ROC curve analysis, it was found that the FA value of the posterior leg of the internal capsule had the highest accuracy in diagnosing HIE, the FA cut off value was 0.545, and the area under the curve was 0.804. the diagnostic sensitivity, specificity and Youden index were 61.4%, 85.9% and 0.473, respectively. According to Spearman correlation, FA values of anterior internal capsule, posterior internal capsule, knee of corpus callosum and pressure of corpus callosum were negatively correlated with HIE severity (all P<0.05). Conclusion: Term in children with HIE, internal capsule, children with severe HIE in fore, internal capsule, corpus callosum, the hind legs knee, corpus callosum FA values than normal full-term neonates significantly lower, and the FA value are negatively related with HIE illness severity, including internal capsule FA value in the diagnosis of HIE efficiency is highest, the hind legs, or can be used as reference indicator of clinical diagnosis of full-term newborn HIE. |
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