發(fā)布時(shí)間：2018-06-22 22:35

  本文選題：磁共振成像 + 新生兒　； 參考：《中國(guó)循證兒科雜志》2015年02期

【摘要】：目的探討磁敏感加權(quán)成像(SWI)在新生兒顱內(nèi)出血的應(yīng)用價(jià)值。方法納入2009年8月至2011年2月復(fù)旦大學(xué)附屬兒科醫(yī)院NICU臨床疑診腦損傷的新生兒,同時(shí)進(jìn)行常規(guī)MRI和SWI掃描。分為足月兒組和早產(chǎn)兒組,統(tǒng)計(jì)常規(guī)MRI和SWI檢測(cè)的出血部位、出血病灶數(shù)目和出血面積的差別。結(jié)果 596例臨床疑診腦損傷的新生兒進(jìn)入分析。1常規(guī)MRI檢出顱內(nèi)出血117例(19.6%),早產(chǎn)兒組72例(61.5%);SWI檢出顱內(nèi)出血134例(22.5%),早產(chǎn)兒組81例(60.4%),包括生發(fā)基質(zhì)出血40例(早產(chǎn)兒33例,足月兒7例),側(cè)腦室出血68例(早產(chǎn)兒54例,足月兒14例),脈絡(luò)叢出血30例(早產(chǎn)兒18例,足月兒12例),第三腦室出血6例(早產(chǎn)兒),中腦導(dǎo)水管出血3例(早產(chǎn)兒),第四腦室出血27例(早產(chǎn)兒23例,足月兒4例),大腦實(shí)質(zhì)出血22例(早產(chǎn)兒14例,足月兒8例),小腦出血20例(早產(chǎn)兒11例,足月兒9例),腦干出血1例(足月兒),蛛網(wǎng)膜下腔出血10例(早產(chǎn)兒4例,足月兒6例),硬膜下出血36例(早產(chǎn)兒17例,足月兒19例),硬膜外出血2例(足月兒)。2生發(fā)基質(zhì)-腦室內(nèi)出血(6個(gè)部位)中,除了中腦導(dǎo)水管出血外,其他5個(gè)部位的出血病灶檢出數(shù)目SWI均大于常規(guī)MRI(P均0.05)。SWI對(duì)蛛網(wǎng)膜下腔出血的檢出數(shù)目大于常規(guī)MRI(P0.05);對(duì)硬膜下出血和硬膜外出血的檢出數(shù)目上,SWI和MRI差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。3SWI序列81例早產(chǎn)兒生發(fā)基質(zhì)-腦室出血主要為生發(fā)基質(zhì)出血(44個(gè))、側(cè)腦室出血(90個(gè))和脈絡(luò)叢出血(26個(gè));53例足月兒生發(fā)基質(zhì)-腦室出血以側(cè)腦室出血(23個(gè))和脈絡(luò)叢出血(18個(gè))多見(jiàn)。498例在SWI和常規(guī)MR同時(shí)顯示出血的病例,顱內(nèi)出血(生發(fā)基質(zhì)-腦室內(nèi)出血、大腦和小腦實(shí)質(zhì)出血)面積(cm2)SWI均大于常規(guī)MRI的T2WI序列,(0.69±0.63)vs(0.49±0.48),P0.001。結(jié)論 SWI較常規(guī)MRI在檢出新生兒各種類型的顱內(nèi)出血和蛛網(wǎng)膜下腔出血的陽(yáng)性率、病灶數(shù)目和出血面積方面有明顯的優(yōu)勢(shì),可作為常規(guī)MRI的有力補(bǔ)充。
[Abstract]:Objective to evaluate the value of magnetic sensitivity weighted imaging (SWI) in neonatal intracranial hemorrhage. Methods from August 2009 to February 2011, neonates with suspected brain injury in NICU, Department of Pediatrics affiliated to Fudan University, were enrolled in the study. Routine MRI and SWI scans were performed at the same time. The patients were divided into term group and premature group. The location of hemorrhage, the number of hemorrhage focus and the area of hemorrhage were measured by conventional MRI and SWI. Results in 596 neonates with suspected brain injury, 117 cases (19.6%) were detected intracranial hemorrhage by conventional MRI, 134 cases (22.5%) were detected by SWI in premature infants group, 81 cases (60.4%) in premature infants group, including 40 cases (33 premature infants) with germinal stroma hemorrhage. There were 7 term infants, 68 cases of lateral ventricular hemorrhage (54 premature infants, 14 term infants), 30 choroidal plexus hemorrhage (18 premature infants), 12 cases of term infants, 6 cases of third ventricle hemorrhage (premature infants), 3 cases of cerebral aqueduct hemorrhage (premature infants), 27 cases of fourth ventricle hemorrhage (23 cases of premature infants, 4 cases of term infants), 22 cases of hemorrhage of cerebral parenchyma (14 cases of premature infants, 14 cases of premature infants), 27 cases (23 cases of premature infants, 4 cases of term infants), 22 cases of hemorrhage of cerebral parenchyma (14 cases of premature infants). There were 8 term infants, 20 cases of cerebellar hemorrhage (11 premature, 9 term), 1 brain stem hemorrhage (full-term), 10 subarachnoid hemorrhage (4 preterm, 6 term), 36 subdural hemorrhage (17 premature). Of the 19 term infants, 2 (term) .2 germinal stroma intraventricular hemorrhage (6 sites), except for mesencephalic aqueduct hemorrhage, 2 cases (term infants), 2 cases (term infants) .2 germinal stroma intraventricular hemorrhage (6 parts), except the mesencephalic aqueduct hemorrhage, The number of lesions detected by SWI was higher than that of conventional MRI (P 0.05). SWI was higher in subarachnoid hemorrhage than in conventional MRI (P0.05), but there was no significant difference between SWI and MRI in the detection of subdural hemorrhage and epidural hemorrhage. (P 0.05) .3SWI sequence 81 cases of premature infants suffered from germinal stroma hemorrhage (44 cases), lateral ventricular hemorrhage (90 cases) and choroid plexus hemorrhage (26 cases). Choroidal plexus hemorrhage (18 cases) was frequently seen in. 498 cases with both SWI and conventional Mr imaging. The area of intracranial hemorrhage (germinal stroma-intraventricular hemorrhage, cerebral and cerebellar parenchyma hemorrhage) was larger than that of conventional MRI T2WI sequence (0.69 鹵0.63) vs (0.49 鹵0.48) (P 0.001). Conclusion compared with conventional MRI, SWI has obvious advantages in detecting various types of intracranial hemorrhage and subarachnoid hemorrhage in neonates, the number of lesions and the area of hemorrhage, which can be used as an effective supplement to conventional MRI.
【作者單位】： 復(fù)旦大學(xué)附屬兒科醫(yī)院放射科;上海市兒童醫(yī)院;上海交通大學(xué)附屬兒童醫(yī)院放射科;復(fù)旦大學(xué)附屬兒科醫(yī)院新生兒科;復(fù)旦大學(xué)附屬華山醫(yī)院放射科;上海市靜安區(qū)中心醫(yī)院放射科;
【分類號(hào)】：R722.151;R445.2

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5 劉s，

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