Sie L T, Barkhof F, Lafeber H N, Valk J, van der Knaap M S
Department of Child Neurology, University Hospital Vrije Universiteit, Amsterdam, The Netherlands.
Eur Radiol. 2000;10(10):1594-601. doi: 10.1007/s003300000482.
The aim of our study was to assess the usefulness of fluid-attenuated inversion recovery (FLAIR) sequences in comparison with conventional spin-echo and inversion MR imaging in neonates for evaluation of myelination and for detection of hypoxic-ischemic brain injury. We reviewed early MR scans of 18 neonates with suspected hypoxic-ischemic brain damage. Myelination could be evaluated with confidence using conventional MR imaging in all but 2 infants; however, the presence of myelin was very difficult to assess on FLAIR images. Overall, 53 lesions or groups of lesions were identified. The FLAIR technique was more sensitive in 11 of the lesions; especially (pre)cystic lesions could be identified much better and more cysts were found. Conventional MR imaging failed to identify 2 of the lesions and was more sensitive in 14 of the lesions; especially punctate hemorrhages and lesions in basal ganglia or thalami could be better determined. The FLAIR technique missed 3 of these lesions. In the remaining 28 lesions conventional MR and FLAIR images were equally diagnostic. The FLAIR technique and conventional MR imaging are complementary in detecting early sequelae of hypoxic-ischemic brain injury in neonates. The FLAIR technique is not suitable for assessing myelination of the neonatal brain; therefore, FLAIR cannot replace conventional MR imaging.
我们研究的目的是评估液体衰减反转恢复（FLAIR）序列相较于传统自旋回波和反转磁共振成像在新生儿中评估髓鞘形成及检测缺氧缺血性脑损伤的有用性。我们回顾了18例疑似缺氧缺血性脑损伤新生儿的早期磁共振扫描。除2例婴儿外，使用传统磁共振成像能够可靠地评估髓鞘形成；然而，在FLAIR图像上很难评估髓磷脂的存在。总体而言，共识别出53个病灶或病灶组。FLAIR技术在11个病灶中更敏感；尤其是（预）囊性病灶能够被更好地识别，且发现了更多囊肿。传统磁共振成像未能识别出2个病灶，在14个病灶中更敏感；尤其是点状出血以及基底节或丘脑的病灶能够被更好地确定。FLAIR技术漏诊了其中3个病灶。在其余28个病灶中，传统磁共振成像和FLAIR图像具有同等的诊断价值。FLAIR技术和传统磁共振成像在检测新生儿缺氧缺血性脑损伤的早期后遗症方面具有互补性。FLAIR技术不适用于评估新生儿脑的髓鞘形成；因此，FLAIR不能取代传统磁共振成像。
