Thakur Neil H, Spencer Andrew J, Kilbride Howard W, Lowe Lisa H
University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA.
South Med J. 2013 Jun;106(6):350-5. doi: 10.1097/SMJ.0b013e3182967d38.
The purpose of this study is to describe the findings and patterns of injury on magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) after whole-body hypothermia treatment for neonatal hypoxic ischemic encephalopathy.
A retrospective review of consecutive term neonates treated with whole-body hypothermia was performed. Data recorded included demographics and MRI and MRS findings, and day of life (DOL) studies were performed. Injury patterns were classified on MRI as deep, cortical, mixed, or diffuse. The relative apparent diffusion coefficient (rADC) was plotted against DOL scanned and the presence of lactate was recorded.
MRI was performed in 44 infants, 34 of whom also underwent MRS. MRI was abnormal in 32% of neonates, 29.5% of whom were imaged at DOL 4 to 8. rADC values were lowest in neonates scanned on DOL 4 and 5 and remained low up to DOL 8. The deep brain nuclei were involved in hypoxic ischemic encephalopathy in 93% of neonates with abnormal MRIs and lactate was identified on MRS in 18% of neonates between DOL 4 and 8.
MRI performed after therapeutic cooling was abnormal in 29.5% of neonates scanned on DOL 4 to 8. Deep nuclear injury was identified in 93% of neonates. Lactate was present on MRS in 18% of neonates, and rADC values were most reduced on MRI between DOL 4 and 8.
本研究旨在描述新生儿缺氧缺血性脑病全身低温治疗后磁共振成像（MRI）和磁共振波谱（MRS）的损伤发现及模式。
对接受全身低温治疗的足月新生儿进行回顾性研究。记录的数据包括人口统计学资料、MRI和MRS检查结果，并进行了日龄（DOL）研究。MRI上的损伤模式分为深部、皮质、混合或弥漫性。绘制相对表观扩散系数（rADC）与扫描日龄的关系图，并记录乳酸的存在情况。
44例婴儿接受了MRI检查，其中34例还接受了MRS检查。32%的新生儿MRI异常，其中29.5%在出生后4至8日龄时进行了成像。在出生后4日龄和5日龄扫描的新生儿中，rADC值最低，直至出生后8日龄仍保持较低水平。93%MRI异常的新生儿深部脑核受累，在出生后4至8日龄的新生儿中，18%的MRS检测到乳酸。
在出生后4至8日龄接受扫描的新生儿中，29.5%在治疗性降温后进行的MRI检查结果异常。93%的新生儿发现深部核损伤。18%的新生儿MRS检测到乳酸，出生后4至8日龄之间MRI上的rADC值降低最为明显。
