Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
Clin Radiol. 2022 Nov;77(11):825-832. doi: 10.1016/j.crad.2022.04.019. Epub 2022 May 29.
To compare frequency and distribution of deep nuclei involvement in isolated basal ganglia and ventrolateral thalamus (BGT) versus combined BGT and watershed (BGT-WS) hypoxic-ischaemic injury (HII).
A retrospective review was undertaken of the magnetic resonance imaging (MRI) reports of children (0-18 years) with isolated BGT or combined BGT-WS HII. The location and extent of deep nuclear injuries were compared between groups using Fisher's exact test.
Of 762 MRI reports, 435 (57%) had isolated BGT and 327 (43%) combined BGT-WS. Isolated BGT showed basal ganglia involvement in 85.1% (n=370) versus 49.8% (n=163) for combined BGT-WS (p<0.01). Sole putamen lesions were more common in isolated BGT (70.3%; 306) versus combined (19.3%; 63; p<0.01). Thalamic involvement was similar between isolated BGT (93.8%; 408) and combined BGT-WS (96.9%; 317; p>0.05). Sole ventrolateral nucleus involvement was more common in isolated BGT (66.6%; 291) while sole pulvinar lesions (25.1%; 82) and whole thalamus lesions (41.6%; 136) were more common in combined BGT-WS (p<0.01). Putamen and ventrolateral nucleus was the most frequent BGT lesion combination in isolated BGT (55.4%) but not in combined BGT-WS (8.6%; p<0.01).
Variations in the frequency of deep nuclear lesions between groups may reflect different underlying pathogenetic mechanisms. Therefore, combined BGT-WS patterns may not necessarily indicate a superimposed profound on partial prolonged HII, as other causes such as neonatal hypoglycaemia may cause these.
比较孤立基底节和腹外侧丘脑（BGT）与联合 BGT 和分水岭（BGT-WS）缺氧缺血性损伤（HII）的深部核团受累的频率和分布。
对 0-18 岁儿童孤立 BGT 或联合 BGT-WS HII 的磁共振成像（MRI）报告进行回顾性分析。使用 Fisher 精确检验比较两组之间深部核损伤的位置和范围。
在 762 份 MRI 报告中，435 份（57%）为孤立 BGT，327 份（43%）为联合 BGT-WS。孤立 BGT 基底节受累发生率为 85.1%（n=370），联合 BGT-WS 为 49.8%（n=163）（p<0.01）。单纯壳核病变在孤立 BGT 中更为常见（70.3%；306），而联合 BGT-WS 中则较少见（19.3%；63；p<0.01）。孤立 BGT 和联合 BGT-WS 的丘脑受累相似（93.8%；408 与 96.9%；317；p>0.05）。单纯腹外侧核受累在孤立 BGT 中更为常见（66.6%；291），而单纯丘脑辐射病变（25.1%；82）和整个丘脑病变（41.6%；136）在联合 BGT-WS 中更为常见（p<0.01）。孤立 BGT 中最常见的 BGT 病变组合是壳核和腹外侧核（55.4%），而联合 BGT-WS 中则较少见（8.6%；p<0.01）。
两组之间深部核团病变的频率差异可能反映了不同的潜在发病机制。因此，联合 BGT-WS 模式不一定表示叠加了深度和持续的 HII，因为其他原因如新生儿低血糖也可能导致这种情况。
