You Jia, Liu Li, Zhang Ming, Fan Yu-Xin, Song Cai-Hong, Zhang Jie
Department of Neonatology, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710006, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2011 Feb;13(2):107-10.
To study the diagnostic value of the signal intensity on T1-weighted images of MRI and proton magnetic resonance spectroscopy (1H MRS) for neonatal hypoxic-ischemic encephalopathy (HIE).
Thirty full-term neonates with HIE admitted into the Department of Neonatology of the First Affiliated Hospital of Medical College, Xi'an Jiaotong University between January, 2007 and December 2009 were enrolled. Ten normal neonates born at the same period served as control group. Cerebral MRI and 1H MRS examinations were performed within 15 days after birth.
In the HIE group, the signal intensity of the posterolateral lentiform nucleus was higher than or equal to that of the posterior limb of internal capsule, but in the control group, the results were opposite, namely, the signal intensity of the postero-lateral lentiform nucleus was lower than that of the posterior limb of internal capsule. The ratios of lactic acid/creatinine and glutamate/creatinine in the basal ganglia and the frontal lobe shown by 1H MRS increased significantly in the HIE group compared with controls (P<0.05 or 0.01). The differences of the signal intensity between the posterolateral lentiform nucleus and the posterior limb of internal capsule were positively correlated with the ratios of lactic acid/creatinine and glutamate/creatinine shown by 1H MRS (P<0.05).
The comparison of the signal intensity between the posterolateral lentiform nucleus and the posterior limb of internal capsule on T1-weighted images of the cerebral MRI is valuable for the diagnosis of neonatal HIE and the accuracy of diagnosis can be improved when combined with 1H MRS.
探讨磁共振成像(MRI)T1加权像信号强度及质子磁共振波谱(1H MRS)对新生儿缺氧缺血性脑病(HIE)的诊断价值。
选取2007年1月至2009年12月在西安交通大学医学院第一附属医院新生儿科收治的30例足月HIE新生儿。同期出生的10例正常新生儿作为对照组。出生后15天内进行头颅MRI及1H MRS检查。
HIE组豆状核后外侧信号强度高于或等于内囊后肢,而对照组相反,即豆状核后外侧信号强度低于内囊后肢。1H MRS显示HIE组基底节及额叶乳酸/肌酸、谷氨酸/肌酸比值较对照组显著升高(P<0.05或0.01)。豆状核后外侧与内囊后肢信号强度差值与1H MRS显示的乳酸/肌酸、谷氨酸/肌酸比值呈正相关(P<0.05)。
头颅MRI的T1加权像上豆状核后外侧与内囊后肢信号强度比较对新生儿HIE诊断有价值,联合1H MRS可提高诊断准确性。