mri及dwi在新生儿低血糖脑损伤中的应用

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1、MRI及DWI在新生儿低血糖脑损伤中的应用郭庆清许祖梅李梅芳(莆田学院附属医院医学影像科351100)【摘要】目的探讨新牛儿低血糖脑损伤的MRI特征及扩散加权成像(DWI)在低血糖脑损伤诊断中的应用价值。方法回顾性分析9例经临床确诊的新生儿低血糖脑损伤病例的MRI资料,所有病例均在出生后1〜7d行MRI检查，扫描序列包括常规T1WLT2WI及DWI序列。结果9例患儿血糖水平在0.2〜1.8mmol/l,平均约0.95mmol/l。常规T1WI表现为受累部位稍低信号4例，稍高信号1例；7例T2WI表现为受累部位稍高信号或灰

2、白质分界不清。9例行DWI扫描均发现斑片状、条状及脑回样高信号，其中受累部位双侧顶枕叶皮层及皮层下白质8例，月并月氐体受累5例，侧脑室旁脑白质受累4例，基底核受累2例，尾状核头部受累1例，所有患儿小脑及脑干均未见异常。结论新生儿低血糖脑损伤以双侧枕顶叶后部脑组织及脐月氐体压部最常受累，常对称性分布，具有一定特征性。DWI序列较常规T1WI及T2WI序列在低血糖脑损伤的诊断及评估上更具优越性。【关键词】低血糖症脑损伤新生儿磁共振成像【中图分类号】R445【文献标识码】A【文章编号】2095-1752(2014)07-006

3、1-02ThevalueofMRIandDWIinthediagnosisofneonatalhypoglycemicbraininjuryGuoQingqing,XUZumei,LIMeifangDepartmentofMedicalImaging,TheAffiliatedHospitalofPutianUniversity,Putian351100【Abstract】Objective：ToinvestigateMRIfeaturesofneonatalhypoglycemicbraininjury(NHBI)an

4、dtoexplorethevalueofdiffusion-weightedimaging(DWI)inthediagnosisofNHBI.Methods：MRimagingfeaturesof9neonateswithNHBIwereretrospectivelyevaluated-Alltheneoateswereperformed1〜7daysoflifewithMRIsequencesincludingTIWI,T2WIandDWI.Results：Thelevelofbloodglucosewas0.2〜1.

5、8mmol/Iin9casesofneonataIhypoglycemia,anaverageabout0.95mmol/1.NHBIshowedslighthypointensity(4cases)andslighthyperintensity(lcases)onTIWIandhyperintense(7cases)andpoorgray-whitedifferentiationonT2WI.AlloftheDWIimagingshowedabnormalities；Theparietalandoccipitalcor

6、texandsubcorticalwhitematterabnornlalitiesoccurredin88.9%(8cases)ofinfantswithhypoglycemiabraininjury,corpuscallosumabnormalitiesoccurredin55.6%(5cases)ofintantswithhypoglycemiabraininjury;theperiventricularwhitematterinjuryoccurredin44.4%(4cases)ofinfantswithhyp

7、oglycemiabraininjury;22.2%(2cases)ofinfantswithhypoglycemiahadbasalgangliaabnormalities’and11.1%(lcase)hadheadofcaudatenucleusabmormality.Therewerenoabnormalsignalincerebellumandbrainsteminallcases.Conclusion：NHBIhassomespecificimagingfeatures.Bilateralposteriorp

8、arietal——occipitalandthespleniumofcorpuscallosumaremostlikelytobeinjuredinNHBbwhichexhibitsamoresymmetricdistribution.DWIissuperiortoTIWIandT2WIinthedetectiono