The Characteristics of Magnetic Resonance Examination in Neonatal Hypoxic-ischemic Encephalopathy and Its Correlation with Brain Injury
Objective To investigate the characteristics of magnetic resonance imaging(MRI)in neonatal hypoxic-ischemic encephalopathy(HIE)and its correlation with brain injury.Methods 115 full-term HIE children admitted to our hospital from March 2018 to March 2023 were selected retrospectively.According to HIE clinical classification,the patients were divided into mild group(n=41),moderate group(n=53)and severe group(n=21).The general information,MRI imaging score and apparent diffusion coefficient(ADC)of the three groups were compared.Pearson correlation test was used to analyze the correlation between MRI imaging scores and brain injury.The predictive value of ADC in diagnosing the risk of brain injury was verified by the ROC curve.Results There was no significant difference among the three groups in the clinical data of gender,gestational age,birth weight,delivery mode,maternal pregnancy complications,perinatal conditions,blurry boundary of gray white matter,deep white matter lateral ventricular wall,cortex and below dots and T1WI high signal(P＞0.05).There were significant differences among the three groups in bilateral thalamus basal ganglia asymmetry,cerebral venous dilatation and intracranial hemorrhage(P＜0.05).The watershed area,basal ganglia/thalamus,posterior limb of internal capsule,brain stem and comprehensive score of MRI imaging in the three groups increased with the deepening of brain injury.The difference was statistically significant(P＜0.05).Pearson analysis showed that watershed area,basal ganglia/thalamus,posterior limb of internal capsule,brain stem and comprehensive score were positively correlated with the degree of brain injury(P＜0.05).ADC value of the three groups increased gradually with the 10th ADC～90th ADC.The 60th ADC～90th ADC,ADCmax,ADCmin,ADC mean in severe group were higher than those in moderate group and mild group.The 60th ADC～90th ADC,ADCmax,ADCmin and ADCmean in the moderate group were higher than those in the mild group.The difference was statistically significant(P＜0.05).ROC analysis results show that the AUC of the 90th ADC is 0.895(95％CI:0.762～0.965).C-index=0.876(95％CI:0.781～0.997).The best cutoff point is 848.19.The sensitivity was 85.78％,and the specificity was 90.36％.The sensitivity of MRI combined with 90th ADC value in diagnosing the degree of brain injury in HIE children(89.77％)was higher than that of the two alone(70.71％and 73.28％).Conclusion The asymmetry of bilateral thalamus basal ganglia,the expansion of cerebral veins and intracranial hemorrhage in HIE children are related to the degree of brain injury.MRI imaging score was positively correlated with the degree of brain injury.The sensitivity of MRI combined with 90th ADC value in diagnosing the degree of brain injury in HIE children was 89.77％.
Magnetic Resonance Imagingthe NewbornHypoxic-ischemic EncephalopathyApparent Diffusion Coefficient
万方数据
维普
