Iwata Osuke, Iwata Sachiko, Tamura Masanori, Nakamura Tomohiko, Hirabayashi Shinnichi, Fueki Noboru, Kondou Yoshiaki, Kihara Hideki
Division of Neonatology, Nagano Children's Hospital, Toyoshima, Nagano, Japan.
Pediatr Int. 2004 Apr;46(2):141-9. doi: 10.1046/j.1442-200x.2004.01874.x.
Neurological disadvantages due to hypoxic ischemic encephalopathy (HIE) are still very serious problems. In order to support the infant with HIE, it is important to evaluate the severity of the brain injury early. The authors performed a magnetic resonance imaging (MRI) study of the neonatal brain in order to assess the clinical value of periventricular low intensities (PVLI) detected on fluid attenuated inversion recovery (FLAIR) imaging.
A total of 451 MRI from 167 preterm and 113 term infants were sorted into groups according to the corrected age at the time of scanning. Intensities in the white matter were then divided into five grades according to the severity of the finding on FLAIR imaging. Chronic abnormalities such as periventricular hyperintensities (PVHI) were also analyzed.
In early MRI, which was obtained before 2 months corrected age, the incidence of PVLI was 63%, while it was only 3% and 0% in the middle (2-8 months) and the late (8-18 months) scans, respectively. Instead of PVLI, PVHI were commonly observed both on late FLAIR imaging (89%) and late T2-weighted imaging (72%). The severity of the white matter damage diagnosed on early FLAIR imaging had a significant correlation with that of late FLAIR imaging.
F-PVLI on early FLAIR imaging would be a good predictor of chronic white matter damage. FLAIR imaging would be also useful in follow-up of infants because of its high sensitivity to the chronic white matter lesion.
缺氧缺血性脑病（HIE）导致的神经功能障碍仍是非常严重的问题。为了支持患有HIE的婴儿，早期评估脑损伤的严重程度很重要。作者进行了一项新生儿脑磁共振成像（MRI）研究，以评估在液体衰减反转恢复（FLAIR）成像上检测到的脑室周围低信号（PVLI）的临床价值。
将167例早产儿和113例足月儿的451份MRI根据扫描时的矫正年龄分组。然后根据FLAIR成像上发现的严重程度将白质信号分为五个等级。还分析了脑室周围高信号（PVHI）等慢性异常情况。
在矫正年龄2个月之前进行的早期MRI中，PVLI的发生率为63%，而在中期（2 - 8个月）和后期（8 - 18个月）扫描中分别仅为3%和0%。在后期FLAIR成像（89%）和后期T2加权成像（72%）上，常见的是PVHI而非PVLI。早期FLAIR成像诊断的白质损伤严重程度与后期FLAIR成像的严重程度显著相关。
早期FLAIR成像上的F - PVLI将是慢性白质损伤的良好预测指标。由于FLAIR成像对慢性白质病变具有高敏感性，因此在婴儿随访中也很有用。
