中国医科大学学报

中国医科大学学报
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  • 中国科技核心期刊
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中国医科大学学报 ›› 2019, Vol. 48 ›› Issue (9): 812-816.doi: 10.12007/j.issn.0258-4646.2019.09.010

• 论著 • 上一篇    下一篇

动脉自旋标记灌注对足月缺氧缺血性脑病新生儿预后的预测价值

李玉泽1, 刘娜1, 佟晶1, 金蓉1, 陈梅2, 卑贵光1   

  1. 1. 北部战区总医院 放射科, 沈阳 110812;
    2. 北部战区总医院 新生儿科, 沈阳 110812
  • 收稿日期:2018-10-15 出版日期:2019-09-30 发布日期:2019-09-12
  • 通讯作者: 卑贵光 E-mail:2023477349@qq.com
  • 作者简介:李玉泽(1976-),男,副主任医师,硕士.
  • 基金资助:
    辽宁省自然科学基金(201602748)

The Value of Arterial Spin Labeling in the Outcome of Full-Term Neonates with Hypoxic-Ischemic Encephalopathy

LI Yuze1, LIU Na1, TONG Jing1, JIN Rong1, CHEN Mei2, BEI Guiguang1   

  1. 1. Department of Radiology, General Hospital of Northern Theater Command, Shenyang 110812, China;
    2. Department of Newborn, General Hospital of Northern Theater Command, Shenyang 110812, China
  • Received:2018-10-15 Online:2019-09-30 Published:2019-09-12

摘要: 目的 探讨三维动脉自旋标记灌注(3D ASL)是否与足月缺氧缺血性脑病(HIE)新生儿的预后相关,并比较ASL与扩散加权成像(DWI)对HIE患儿预后的预测价值。方法 选择2016年5月至2018年5月我院临床诊断为HIE的足月新生儿30例,其中,中度27例,重度3例,均行常规MR(T1WI、T2WI、T2FLAIR)及ASL、DWI检查。将所有患儿根据预后评估结果分为预后不良组和预后良好组。感兴趣区(ROI)选择双侧基底节、丘脑,测量2组脑血流量(rCBF)值和表观扩散系数(ADC)值,分析组间各ROI的rCBF值和ADC值的差异以及2组rCBF值和ADC值的相关性。结果 预后不良组和预后良好组基底节及丘脑灌注平均值分别为(47.73±3.56)mL·100 g-1·min-1和(39.60±1.60)mL·100 g-1·min-1,差异有统计学意义(P<0.01)。rCBF值的受试者工作曲线下面积(AUC)为0.984,敏感度和特异度分别为100%和76.24%。预后不良组和预后良好组ADC平均值分别为(1.10±0.04)×10-3mm-2·s-1和(1.16±0.36)×10-3 mm-2·s-1,差异具有统计学意义(P<0.01)。ADC值的AUC为0.873。Pearson相关分析表明2组平均rCBF值和ADC值具有相关性(r=-0.54,P<0.01)。结论 HIE患儿脑高灌注与不良预后相关,ASL对足月HIE患儿预后的预测价值高于DWI。

关键词: 缺氧缺血性脑病, 足月新生儿, 动脉自旋标记灌注成像, 预后, 磁共振扩散加权成像

Abstract: Objective To evaluate the correlation between 3D arterial spin labeling (3D ASL) values and outcome in full-term neonates with hypoxic-ischemic encephalopathy (HIE) and to compare the predictive value of 3D-ASL with that of diffusion-weighted imaging (DWI). Methods Thirty full-term HIE neonates were selected,of which 27 had moderate HIE and 3 had severe HIE,which were diagnosed based on the diagnosis standard of HIE. All neonates underwent conventional magnetic resonance imaging examinations (T1WI, T2WI,T2FLAIR),ASL and DWI. All moderate-severe HIE neonates were divided into adverse group and favourable group according to their outcome. Regions of interest (ROIs) were selected at the bilateral basal ganglia and thalami.The relative cerebral blood flow (rCBF) and apparent diffusion coefficient (ADC) values were measured. The differences of rCBF values in the basal ganglia and thalami of two groups were analyzed. The ADC values were similarly assessed. The correlation between the mean rCBF value and the mean ADC value was evaluated. Results The mean perfusion values of the adverse outcome group and the favorable outcome group were 47.73±3.56 mL·100 g-1·min-1 and 39.60±1.60 m·100 g-1·min-1 respectively,and the difference was significant (P<0.01).The area under the concentration-time curve of rCBF value was 0.984. The sensitivity and the specificity of rCBF value were 100% and 76.24%,respectively. The mean ADC values of the adverse outcome group and the favorable outcome group were significantly different at 1.10±0.04 mL·100 g-1·min-1 and 1.16±0.36 mL·100 g-1·min-1,respectively (P<0.01). The AUC was 0.873. Pearson correlation analysis demonstrated that the mean rCBF value and the ADC value were correlated (r=-0.54,P<0.01). Conclusion Higher ASL perfusion values in HIE neonates are associated with adverse outcome. The predictive value of ASL in the outcome of HIE neonates is higher than DWI.

Key words: hypoxic-ischemic encephalopathy, full-term neonate, arterial spin labeling, outcome, diffusion magnetic resonance imaging

中图分类号: 

  • R722.1
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