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目的探讨扩散张量成像(DTI)的分数各向异性(FA)值在评价足月新生儿缺氧缺血性脑病(HIE)的应用价值。方法选择36例临床诊断为HIE的足月新生儿,分为轻、中和重度组,随机选择12例健康足月新生儿为对照。所有病例在生后一周内和6个月左右行DTI检查,测量内囊前肢、后肢、额叶白质、颞叶白质、顶叶白质和枕叶白质的FA值,并进行比较。结果出生后一周内DTI检查:中度组额叶、顶叶白质FA值较对照组降低,重度组内囊前肢、额叶、颞叶、顶叶和枕叶白质的FA值较对照组减低;重度组额叶、顶叶、枕叶白质FA值较轻度组减低,重度组额叶白质FA值较中度组降低,均有统计学差异(P<0.05)。6个月后复查:重度组额叶和顶叶白质FA值较对照组低,有统计学差异(P<0.05)。结论 DTI可对足月产HIE患儿脑白质病变进行定量观测,评价其病情,为评估新生儿缺氧缺血性脑病患者的预后提供有效依据,值得临床推广应用。
Objective To investigate the value of fractional anisotropy (FA) of diffusion tensor imaging (DTI) in assessing neonatal hypoxic-ischemic encephalopathy (HIE) in term infants. Methods Thirty-six full-term newborns diagnosed as HIE were randomly divided into mild, moderate and severe groups, and 12 healthy full-term newborns were randomly selected as control. DTI was performed in all cases within one week and six months after birth. The FA values of forelimb, hindlimb, frontal white matter, temporal lobe white matter, parietal white matter and occipital white matter were measured and compared. Results In the first week after birth, the DTI examination showed that FA value of frontal lobe and parietal white matter of moderate degree group was lower than that of control group. FA value of forelimb, frontal lobe, frontal lobe, temporal lobe, parietal lobe and occipital lobe in severe group was lower than that in control group. The FA in the frontal lobe, parietal lobe and occipital lobe in severe group was lower than that in the mild group, and the FA value in the frontal lobe in the severe group was lower than that in the moderate group (P <0.05). After 6 months of review: severe group of frontal lobe and parietal white matter FA values ?? lower than the control group, with statistical differences (P <0.05). Conclusions DTI can quantitatively observe and assess the white matter lesions in children with full-term HIE and provide an effective basis for evaluating the prognosis of neonates with hypoxic-ischemic encephalopathy. It is worthy of clinical application.