Nalbant Mustafa Orhan, Erdil Irem, Akcay Nihal, Inci Ercan, Palabiyik Figen
Department of Radiology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, Bakırkoy, Istanbul, Turkey.
Department of Paediatric Intensive Care, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, Bakırkoy, Istanbul, Turkey.
Pol J Radiol. 2023 Sep 6;88:e399-e406. doi: 10.5114/pjr.2023.131696. eCollection 2023.
To evaluate the whole brain, hippocampus, thalamus, and lentiform nucleus by volumetric apparent diffusion coefficient (ADC) histogram analysis in paediatric patients with hypoxic-ischaemic encephalopathy (HIE).
This retrospective study included 25 patients with HIE and 50 patients as the control group. Diffusion-weighted imaging was obtained at -values of 1000 mm/s. The histogram parameters of ADC values, including the mean, minimum, maximum, 5, 10, 25, 50, 75, 90, and 95 percentiles, as well as skewness, kurtosis, and variance were determined. The interclass correlation coefficient (ICC) was used to assess the inter-observer agreement.
ADC, ADC, and ADC, as well as the 5, 10, 25, 50, 75, 90, and 95 percentiles of ADC values for the HIE group were all lower than those of the control group ( < 0.001) in the volumetric histogram analysis of the hippocampus, thalamus, and lentiform nucleus. In the whole-brain histogram analysis, ADC min, and the 50 and 75 percentiles of ADC values did not differ significantly, while other parameters were lower in the HIE group. The ROC curve revealed that the ADC histogram parameters of the hippocampus provided the most accurate results for the diagnosis of HIE. The area under the curve (AUC) of the 95 percentile of ADC values was the highest (AUC = 0.915; cut-off 1.262 × 10 mm/s; sensitivity 88% and specificity 84%).
Volumetric ADC histogram analysis of the whole brain, hippocampus, thalamus, and lentiform nucleus with -values of 1000 mm/s can serve as an imaging marker for determining HIE.
通过对缺氧缺血性脑病（HIE）患儿进行全脑、海马、丘脑和豆状核的体积表观扩散系数（ADC）直方图分析来进行评估。
这项回顾性研究纳入了25例HIE患儿和50例作为对照组的患儿。在1000mm²/s的b值下获得扩散加权成像。确定ADC值的直方图参数，包括均值、最小值、最大值、第5、10、25、50、75、90和95百分位数，以及偏度、峰度和方差。组内相关系数（ICC）用于评估观察者间的一致性。
在海马、丘脑和豆状核的体积直方图分析中，HIE组的ADC均值、ADC最小值和ADC最大值，以及ADC值的第5、10、25、50、75、90和95百分位数均低于对照组（P<0.001）。在全脑直方图分析中，ADC最小值以及ADC值的第50和75百分位数无显著差异，而HIE组的其他参数较低。ROC曲线显示，海马的ADC直方图参数对HIE诊断的结果最准确。ADC值第95百分位数的曲线下面积（AUC）最高（AUC = 0.915；截断值1.262×10⁻³mm²/s；敏感性88%，特异性84%）。
在1000mm²/s的b值下对全脑、海马、丘脑和豆状核进行体积ADC直方图分析可作为确定HIE的影像学标志物。
