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[新生儿低血糖性脑病的典型与非典型磁共振成像表现]

[Typical and non-typical magnetic resonance imaging findings of neonatal hypoglycemic encephalopathy].

作者信息

Wang Yongjiao, Liu Kun, Ye Xinjian, Lu Yi, Zhang Xiaoxia, Zhang Chengbing, He Lei, Yan Zhihan

机构信息

Department of Radiology, Second Affiliated Hospital, Wenzhou Medical University, Wenzhou 32500, China.

Department of Radiology, Second Affiliated Hospital, Wenzhou Medical University, Wenzhou 32500, China. Email:

出版信息

Zhonghua Yi Xue Za Zhi. 2014 Oct 14;94(37):2938-40.

Abstract

OBJECTIVE

To analyze the typical and non-typical magnetic resonance imaging (MRI) findings of neonatal hypoglycemia encephalopathy (NHE).

METHODS

The clinical data and MRI findings of 20 cases with NHE were retrospectively evaluated.

RESULTS

Among them, blood glucose values were ≤ 1.4 mmol/L (n = 18) and 2.1 mmol/L (n = 2). And 13 cases had recurrent hypoglycemia. The major clinical symptoms included convulsion, poor response, cyanosis and apnea. The typical MRI findings of abnormal signal in occipital or parietal cortex were found in 9 cases. And the involvement sites were corpus callosum (n = 4) and posterior limb of internal capsule (n = 1). Another 11 cases revealed non-typical MRI findings of damaged brain regions, involving splenium of corpus callosum (n = 8), white matte along lateral ventricle (n = 6), extensive cortical or subcortical white matter (n = 5), internal capsule (n = 3), centrum semiovale (n = 2), globus pallidus (n = 1), local cortex (frontal lobe) (n = 1), pons (n = 1), unilateral hippocampus (n = 1) and bilateral thalamus and midbrain, brain stem and medulla oblongata (n = 1).

CONCLUSION

The typical MRI findings of NHE show abnormal signal in occipital or parietal cortex. And non-typical manifestations involving multiple brain areas may be observed in cases of severe NHE.

摘要

目的

分析新生儿低血糖脑病(NHE)的典型及非典型磁共振成像(MRI)表现。

方法

回顾性分析20例NHE患儿的临床资料及MRI表现。

结果

其中,血糖值≤1.4 mmol/L者18例,2.1 mmol/L者2例。13例有反复低血糖情况。主要临床症状包括惊厥、反应差、发绀及呼吸暂停。9例患儿MRI表现为枕叶或顶叶皮质异常信号,为典型表现。受累部位有胼胝体(4例)和内囊后肢(1例)。另外11例表现为非典型MRI表现,脑区受损部位包括胼胝体压部(8例)、侧脑室旁白质(6例)、广泛皮质或皮质下白质(5例)、内囊(3例)、半卵圆中心(2例)、苍白球(1例)、局部皮质(额叶)(1例)、脑桥(1例)、单侧海马(1例)以及双侧丘脑、中脑、脑干和延髓(1例)。

结论

NHE的典型MRI表现为枕叶或顶叶皮质异常信号。重度NHE病例可观察到累及多个脑区的非典型表现。

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