Steinlin M, Dirr R, Martin E, Boesch C, Largo R H, Fanconi S, Boltshauser E
Department of Neurology, Children's University Hospital, Zurich, Switzerland.
Pediatr Neurol. 1991 May-Jun;7(3):164-70. doi: 10.1016/0887-8994(91)90079-z.
In 30 children suffering from severe perinatal asphyxia an attempt was made to determine the early prognostic signs of severe hypoxic-ischemic brain injury with magnetic resonance imaging (MRI). Ten early (1-4 days of age), 16 intermediate (2-4 weeks of age), and 38 late MRI (older than 1 month of age) procedures were performed on a 2.35 T MR-system. Severe cerebral necrosis was suspected by T2 hyperintensity of the white matter, with blurred limits to the cortex in early MRI, and was confirmed by T1 hyperintensity of the cortex in intermediate MRI. Severe cerebral necrosis was established at 3 months of age. Of the 11 children with this pattern (group A), 8 had severe and 3 had moderate cerebral palsy on subsequent examination. Thirteen children (group B) had normal late MRI scans; none developed severe cerebral palsy or marked mental retardation. Two children (group C) had focal ischemic lesions. Four children had intracranial hemorrhage (group D). Groups A and B did not differ in the severity of their perinatal histories and findings, suggesting that MRI during the first 3 months is of significant prognostic value.
对30例患有严重围产期窒息的儿童，尝试通过磁共振成像（MRI）确定严重缺氧缺血性脑损伤的早期预后征象。在一台2.35T MR系统上，分别对10例患儿进行了早期（出生1 - 4天）、16例进行了中期（出生2 - 4周）以及38例进行了晚期（出生1个月以上）的MRI检查。早期MRI检查时，白质T2高信号提示严重脑坏死，其边界向皮质模糊，中期MRI检查时皮质T1高信号证实了严重脑坏死。在3个月大时确诊为严重脑坏死。在后续检查中，有11例呈现此模式的儿童（A组），其中8例患有严重脑瘫，3例患有中度脑瘫。13例儿童（B组）晚期MRI扫描正常；无一例发展为严重脑瘫或明显智力发育迟缓。2例儿童（C组）有局灶性缺血性病变。4例儿童有颅内出血（D组）。A组和B组在围产期病史和检查结果的严重程度上无差异，这表明在出生后3个月内进行MRI检查具有重要的预后价值。
