T1WI信号强度与1H MRS在新生儿缺氧缺血性脑病诊断中的价值

Diagnostic value of the signal intensity on T1-weighted images of MRI and 1H MRS for neonatal hypoxic-ischemic encephalopathy

摘要:

目的：探讨T1加权的信号强度和氢质子波谱（1H MRS）在新生儿缺氧缺血性脑病（HIE）诊断中的价值。方法：收集2007年1月至2009年12月西安交通大学医学院第一附属医院新生儿科收治的HIE患儿30名为HIE组，选择该院同期出生的正常足月儿10名为对照组，所有研究对象在出生15 d内行头颅磁共振检查。结果：①HIE组的后外侧豆状核信号强度高于或等于内囊后肢的信号强度，对照组后外侧豆状核信号强度低于内囊后肢的信号强度，信号强度的对比在两组间的差异有统计学意义（P<0.01）；②额叶与基底核的乳酸/肌酐、谷氨酸盐/肌酐比值在HIE组中明显升高，二者的比值在两组间的差异有统计学意义（P<0.05 或0.01）。③后外侧豆状核与内囊后肢的信号强度与1H MRS的乳酸/肌酐、谷氨酸盐/肌酐比值呈显著正相关（P<0.05）。结论：MRI中后外侧豆状核与内囊后肢在T1加权上的信号强度对比对新生儿HIE具有较高的诊断价值，其与1H MRS相结合有利于提高HIE诊断准确性。

Abstract:

OBJECTIVE: To study the diagnostic value of the signal intensity on T1-weighted images of MRI and proton magnetic resonance spectroscopy (1H MRS) for neonatal hypoxic-ischemic encephalopathy (HIE). METHODS: Thirty full-term neonates with HIE admitted into the Department of Neonatology of the First Affiliated Hospital of Medical College, Xi′an Jiaotong University between January, 2007 and December 2009 were enrolled. Ten normal neonates born at the same period served as control group. Cerebral MRI and 1H MRS examinations were performed within 15 days after birth. RESULTS: In the HIE group, the signal intensity of the posterolateral lentiform nucleus was higher than or equal to that of the posterior limb of internal capsule, but in the control group, the results were opposite, namely, the signal intensity of the postero-lateral lentiform nucleus was lower than that of the posterior limb of internal capsule. The ratios of lactic acid/creatinine and glutamate/creatinine in the basal ganglia and the frontal lobe shown by 1H MRS increased significantly in the HIE group compared with controls (P<0.05 or 0.01). The differences of the signal intensity between the posterolateral lentiform nucleus and the posterior limb of internal capsule were positively correlated with the ratios of lactic acid/creatinine and glutamate/creatinine shown by 1H MRS (P<0.05). CONCLUSIONS: The comparison of the signal intensity between the posterolateral lentiform nucleus and the posterior limb of internal capsule on T1-weighted images of the cerebral MRI is valuable for the diagnosis of neonatal HIE and the accuracy of diagnosis can be improved when combined with 1H MRS.