Brissaud Olivier, Chateil Jean-François, Bordessoules Martine, Brun Muriel
Paediatric Intensive Care Unit, Children's Hospital, Place Amélie Raba Léon, Bordeaux 33076, France.
Pediatr Radiol. 2005 Oct;35(10):998-1005. doi: 10.1007/s00247-005-1524-5. Epub 2005 Jun 17.
Diagnosis of brain lesions after birth anoxia-ischemia is essential for appropriate management. Clinical evaluation is not sufficient. MRI has been proven to provide useful information.
To compare abnormalities observed with MRI, including diffusion-weighted imaging (DWI), localised magnetic resonance spectroscopy (MRS) and chemical shift imaging (CSI) and correlate these findings with the clinical outcome.
Fourteen full-term neonates with birth asphyxia were studied. MRI, MRS and CSI were performed within the first 4 days of life.
Lesions observed with DWI were correlated with outcome, but the apparent diffusion coefficient (ADC) did improve diagnostic confidence. The mean value of Lac/Cr for the neonates with a favourable outcome was statically lower than for those who died (0.22 vs 1.04; P = 0.01). The same results were observed for the Lac/NAA ratio (0.21 vs 1.23; P = 0.01). Data obtained with localised MRS and CSI were correlated for the ratio N-acetyl-aspartate/choline, but not for the other metabolites. No correlation was found between the ADC values and the metabolite ratios.
Combination of these techniques could be helpful in our understanding of the physiopathological events occurring in neonates with asphyxia.
出生后缺氧缺血性脑损伤的诊断对于恰当的治疗至关重要。临床评估并不充分。磁共振成像（MRI）已被证明能提供有用信息。
比较MRI观察到的异常情况，包括弥散加权成像（DWI）、局部磁共振波谱分析（MRS）和化学位移成像（CSI），并将这些发现与临床结果相关联。
对14例足月窒息新生儿进行研究。在出生后4天内进行MRI、MRS和CSI检查。
DWI观察到的病变与预后相关，但表观扩散系数（ADC）确实提高了诊断可信度。预后良好的新生儿的Lac/Cr平均值显著低于死亡者（0.22对1.04；P = 0.01）。Lac/NAA比值也得到相同结果（0.21对1.23；P = 0.01）。局部MRS和CSI获得的数据在N - 乙酰天门冬氨酸/胆碱比值方面相关，但在其他代谢物方面不相关。ADC值与代谢物比值之间未发现相关性。
这些技术的联合应用有助于我们理解窒息新生儿发生的生理病理事件。
