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目的评价MRI对缺氧缺血性脑病(HIE)患儿新生儿期及神经后遗症期随访的价值。方法回顾性分析81例HIE新生儿期及神经后遗症期的常规MRI表现及影像结果。对81例HIE患儿进行2次以上头部MR复查,首次在新生儿期,第2次在4月~4岁。足月儿66例,早产儿15例。结果81例中,2次复查后MRI异常79例(97.5%)。其中:髓鞘化异常59例(72.8%),外部性脑积水53例(65.4%),脑软化26例(32.1%),脑萎缩25例(30.9%),脑白质减少24例(29.6%)及胼胝体发育不良9例(11.1%)。轻度者复查常为外部性脑积水(26/35例)及局限性髓鞘化异常(16/35例),而中度患儿则伴有脑软化灶(12/29例),重度患儿常见脑萎缩(16/17例)或脑白质减少(15/17例)。结论常规MRI可准确反映HIE及神经后遗症期脑的形态学改变,为HIE早期干预和评估预后提供了客观依据。
Objective To evaluate the value of MRI in the follow-up of neonatal and neurological sequelae in children with hypoxic-ischemic encephalopathy (HIE). Methods A retrospective analysis of 81 cases of HIE neonatal and neurological sequelae of conventional MRI findings and imaging results. 81 cases of HIE in children with head MR more than 2 times, the first in neonatal period, the second in April to 4 years. 66 cases of full-term children, 15 cases of premature children. Results Among the 81 cases, 79 cases (97.5%) had abnormal MRI after 2 times of reexaminations. There were 59 cases (72.8%) of myelination abnormalities, 53 cases (65.4%) of external hydrocephalus, 26 cases (32.1%) of brain softening, 25 cases of brain atrophy (30.9%) and 24 cases %) And corpus callosum dysplasia in 9 cases (11.1%). Mild reexamination often external hydrocephalus (26/35 cases) and limitations of myelination abnormalities (16/35 cases), while moderate children are accompanied by cerebral softening (12/29 cases), severe Children with common brain atrophy (16/17 cases) or white matter reduction (15/17 cases). Conclusion Conventional MRI can accurately reflect the morphological changes of brain during HIE and neurological sequelae, and provide an objective basis for early HIE intervention and assessment of prognosis.