Application of Magnetic Resonance Spectroscopy Imaging Combined with Diffusion Weighted Imaging in the Diagnosis and Prognosis Evaluation of Brain White Matter Injury in Premature Infants
Objective To explore the application value of magnetic resonance spectroscopy(MRS)combined with diffusion weighted imaging(DWI)in the early diagnosis and prognosis evaluation of brain white matter injury in premature infants.Methods 102 premature infants with brain white matter injury from January 2021 to January 2023 were selected as the case group,while 98 premature infants without brain white matter injury were selected as the control group.Clinical indicators related to premature infants were recorded in both groups,and MRS and DWI examinations were performed 7 days after birth.The differences of MRS metabolic indexes and DWI parameters between the two groups were compared.The relationship between MRS metabolic indexes,DWI parameters and white matter injury in premature infants was tested by point two column correlation.The receiver operating curve(ROC)was drawn to analyze the early diagnostic value of MRS combined with DWI for white matter injury in premature infants.Long term follow-up was given to the case group of children.At the corrected age of 6 months,the children were divided into a poor prognosis group and a good prognosis group using the Gesell developmental diagnostic scale.The evaluation value of MRS metabolic indicators and DWI parameters on the prognosis of premature brain white matter injury in the two groups of children was compared and analyzed.Results The N-acetylaspartic acid(NAA),NAA/Cr,rADC in the case group were significantly lower than those in the control group,while creatine(Cr)was significantly higher than that in the control group,with statistical significant differences(P＜0.05).The point two column correlation test showed a negative correlation between NAA,NAA/Cr,rADC and brain white matter injury in premature infants(r＜0,P＜0.05).There was a positive correlation between Cr and white matter damage in premature infants(r＞0,P＜0.05).ROC curve showed that NAA,Cr,NAA/Cr and rADC had low diagnostic value in the diagnosis of brain white matter injury in premature infants,with AUC of 0.629,0.630,0.605 and 0.603,respectively.MRS combined with DWI had a good diagnostic value,with an AUC of 0.713.The follow-up results showed that among the 102 patients,21 were in marginal state,53 were developmental abnormalities,a total of 74 were in the poor prognosis group,and the other 28 were in the good prognosis group with good development.The levels of NAA,NAA/Cr,and rADC in the poor prognosis group were significantly lower than those in the good prognosis group,while Cr was significantly higher than that in the good prognosis group,with a statistical significant difference(P＜0.05).The point two column correlation test showed a negative correlation between NAA,NAA/Cr,rADC and poor prognosis in children with brain white matter injury(r＜0,P＜0.05).There was a positive correlation between Cr and poor prognosis(r＞0,P＜0.05).ROC curve showed that NAA,NAA/Cr and rADC had low evaluation value for the prognosis of children with white matter injury,with AUC of 0.641,0.639 and 0.688,respectively.The combination of Cr,MRS,and DWI had good prognostic value for children with brain white matter injury,with AUC of 0.755 and 0.833,respectively,with the highest combined evaluation value.Conclusion The combination of MRS and DWI has good evaluation value for brain white matter injury and prognosis in premature infants.
Magnetic Resonance Spectroscopy ImagingDiffusion Weighted imagingBrain Brain White Matter InjuryPremature InfantsPrognosis
万方数据
维普
