目的 为新生儿缺氧缺血性脑病（HIE）的早期定量诊断提供新的影像诊断依据。 方法 选取动脉自旋标记（ASL）灌注加权成像检查的20名不同日龄正常新生儿和40例不同程度新生儿HIE患儿，在图像后处理工作站划分脑结构的感兴趣区（ROI），测量ROI的脑血流量（CBF）。比较不同日龄脑结构ROI及其与HIE患儿相应ROI的CBF值。 结果 不同日龄脑结构的尾状核头、豆状核、背侧丘脑、额叶白质和各日龄组ROI的CBF值均有统计学意义（P<0.05），CBF值随着出生日龄增大则逐渐升高，且脑神经核的CBF值明显大于额叶白质。观测组的尾状核头、豆状核、背侧丘脑、额叶白质的CBF值分别为(30.75±1.05) mL/100g·min、(32.02±0.97) mL/100g·min、(39.13±1.36)mL/100g·min、(15.89±0.89) mL/100g·min，与轻、中、重度病变组相应ROI的CBF值均有统计学意义（P<0.05），且尾状核头、豆状核和背侧丘脑的CBF值随着病情加重则逐渐升高，而额叶白质的CBF值则随着病情加重则逐渐降低。 结论 基底神经核和背侧丘脑是新生儿脑结构中对缺血缺氧极为敏感的部位，ASL灌注加权成像的CBF 值可以早期反映HIE患儿脑结构的再灌注水平和损伤程度。
Abstract
Objective To provide new imaging diagnostic basis for the early quantitative diagnosis of neonatal hypoxic-ischemic encephalopathy (HIE). Methods Twenty normal neonates with check of different ages and 40 neonates with HIE of different degrees were selected by arterial spin labeling (ASL) perfusion weighted imaging examination. At the image post-processing workstation, the regions of interest (ROI) of brain structure were divided, and the cerebral blood flow (CBF) value of ROI were measured. The CBF values of brain structure ROI among the different ages and its corresponding ROI in HIE were compared. Results There were statistical significance in the head of caudate nucleus, lenticular nucleus, dorsal thalamus, frontal white matter and the CBF values of ROI in different age groups (P<0.05). The CBF value increased gradually with the increasing of birth age, and the CBF value of the brain nucleus was significantly higher than that of frontal white matter. The CBF values of the head of caudate nucleus, lenticular nucleus, dorsal thalamus and frontal white matter in the observation group were (30.75±1.05) mL/100g·min, (32.02±0.97) mL/100g·min, (39.13±1.36) mL/100g·min, (15.89±0.89) mL/100g·min respectively. There were statistical significances in the CBF value of ROI among the observation group and the mild, moderate, severe lesions groups (P<0.05). The CBF value of the head of caudate nucleus, lenticular nucleus and dorsal thalamus increased gradually with the severity of the disease, while the CBF value of the frontal white matter decreased gradually with the severity of the disease. Conclusions The basal ganglia and dorsal thalamus are the most sensitive parts in the neonatal brain structure to ischemia and hypoxia, the CBF value of ASL perfusion weighted imaging can reflect the level of reperfusion and the degree of injury in the brain structure of HIE in early stage.
关键词
脑结构； /
动脉自旋标记灌注加权成像； /
/
新生儿； /
/
CBF值； /
/
缺氧缺血性脑病
Key words
Brain structure; /
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Arterial spin labeled perfusion weighted imaging; /
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Neonate; /
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Cerebral blood flow value; /
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Hypoxic-ischemic encephalopathy
中图分类号：
脑结构
动脉自旋标记灌注加权成像
新生儿
CBF值
缺氧缺血性脑病
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基金
河南省医学科技攻关联合共建项目(LHGJ20220641); 河南省高等学校重点科研项目计划(22B310012)
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