Clinical value of magnetic resonance imaging ADC combined with serum IGF-1 level in the diagnosis and prognosis of PWML in premature infants
Objective To investigate the clinical value of magnetic resonance imaging(MRI)apparent diffusion coefficient(ADC)combined with serum insulin-like growth factor 1(IGF-1)level in the diagnosis and prognosis of punc-tate white matter lesions(PWML)in preterm infants.Methods Totally 114 preterm infants with PWML were selected(observation group),including 35 cases with mild PWML,46 cases with moderate PWML,33 cases with severe PWML,during which,85 cases had good prognosis after standard treatment and 29 cases had poor prognosis;and 34 preterm infants without cranial diseases(control group)were selected during the same period.Brain MRI was performed on all pre-term infants within 2 weeks of birth.Diffusion tensor imaging(DTI)scan was performed routinely,and ADC was mea-sured in areas of interest.Peripheral venous blood was collected,serum was collected by centrifugation,and serum IGF-1 was detected by ELISA.Receiver operating characteristic(ROC)curve was used to analyze the clinical value of ADC and serum IGF-1 levels in the diagnosis and prognosis of PWML preterm infants.Results The levels of ADC and IGF-1 in the observation group were lower than those in the control group(both P<0.05).The levels of ADC and serum IGF-1 in PWML preterm infants decreased gradually with the increase of disease severity(both P<0.05).The levels of ADC and IGF-1 in patients with poor prognosis were lower than those in patients with good prognosis(both P<0.05).The area under the curve(AUC)of ADC and serum IGF-1 levels for PWML in preterm infants were 0.772,0.762 and 0.960,respectively,and the AUC of ADC and serum IGF-1 levels for PWML in preterm infants was higher than that of ADC and serum IGF-1 levels alone(Z=3.951 and 5.033,respectively;both P<0.05).The levels of ADC and serum IGF-1 in PWML preterm infants with poor prognosis were lower than those of PWML preterm infants with good prognosis(both P<0.05).The AUC values of ADC and serum IGF-1 alone and combined in predicting the prognosis of PWML preterm infants were 0.722,0.636 and 0.950,respectively,and the AUC value of ADC combined with serum IGF-1 in predicting the prognosis of PWML preterm infants was higher than that of ADC or serum IGF-1 alone(Z= 3.887 and 5.292,respectively,both P<0.05).Conclusions The levels of ADC and IGF-1 in PWML preterm infants decrease,which are related to the severity and prognosis of PWML preterm infants.ADC and serum IGF-1 levels have certain predictive value for the diagnosis and prognosis of PWML premature infants,and their combined predictive value is higher.
white matter injurypremature infantsapparent diffusion coefficientinsulin-like growth factor 1
万方数据
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