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围产期窒息病例的脑弥散变化。

Brain Diffusion Changes in Perinatal Asphyxia Cases.

机构信息

Department of Radiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey.

Department of Pediatric, Faculty of Medicine, Harran University, Sanliurfa, Turkey.

出版信息

Niger J Clin Pract. 2024 Aug 1;27(8):1027-1032. doi: 10.4103/njcp.njcp_281_24. Epub 2024 Aug 26.

Abstract

BACKGROUND

Prolonged perinatal asphyxia (PA) may cause hypoxic-ischemic damage to the brain. The aim of this study was to investigate the brain diffusion changes of patients with PA and examine the relationship with brain damage.

METHODS

This retrospective study included 55 patients diagnosed with PA, separated into mild and severe PA groups. For the evaluation of brain damage in all the study neonates, brain and diffusion MRI scans were performed using a 3T device. The scans were taken between 5 and 10 days postnatal, after completion of hypothermia treatment, in accordance with the standard clinical protocol of our institution. Apparent diffusion coefficient (ADC) values of the lentiform nucleus, thalamus, frontal white matter, and posterior limbs of the internal capsule were measured. Minitab package programs and SPSS version 20.0 software were used for statistical analysis and graphic drawing. Spearman's rank correlation analysis was used.

RESULTS

The bilateral lentiform nucleus, thalamus, frontal white matter, and posterior limbs of the internal capsule ADC values were significantly higher in the severe PA group than in the mild PA group.

CONCLUSIONS

In neonates with severe perinatal asphyxia, brain damage can be evaluated on diffusion-weighted imaging (DWI) of the cerebral deep white matter and basal ganglia. DWI, imaging with conventional brain MRI comes to the fore in clinical importance in PA patients.

摘要

背景

围产期延长窒息(PA)可能导致脑缺氧缺血性损伤。本研究旨在探讨 PA 患者的脑弥散变化,并探讨其与脑损伤的关系。

方法

本回顾性研究纳入了 55 名诊断为 PA 的患者,分为轻度和重度 PA 组。为了评估所有研究新生儿的脑损伤,使用 3T 设备进行脑和弥散 MRI 扫描。扫描在体温降低治疗完成后,于出生后 5-10 天内,根据我们机构的标准临床方案进行。测量豆状核、丘脑、额叶白质和内囊后肢的表观扩散系数(ADC)值。使用 Minitab 程序包程序和 SPSS 版本 20.0 软件进行统计分析和图形绘制。采用 Spearman 秩相关分析。

结果

重度 PA 组双侧豆状核、丘脑、额叶白质和内囊后肢 ADC 值明显高于轻度 PA 组。

结论

在重度围产期窒息的新生儿中,可以在大脑深部白质和基底节的弥散加权成像(DWI)上评估脑损伤。DWI 在 PA 患者中的临床重要性优于常规脑 MRI 成像。

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