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目的探讨磁敏感加权成像(SWI)在新生儿颅内出血的诊断价值,并比较早产儿与足月儿间的差别。方法对115例怀疑脑损伤的新生儿行常规MRI、DWI和SWI检查,明确有无颅内出血并记录各序列出血灶个数,比较3种方法在颅内出血检出率、分布区域及病灶检出个数的差异,并比较早产儿与足月儿间颅内出血分布区域及病灶检出个数的差异。结果 115例新生儿中,SWI的颅内出血检出率高于常规MRI及DWI(检出率分别为32.2%、26.1%、12.2%,P<0.05),常规MRI亦较DWI高(P<0.05)。37例颅内出血新生儿,常规MRI、DWI及SWI检出颅内出血灶分别为66、33、125个,SWI较常规MRI及DWI、常规MRI较DWI显示更多出血灶(均P<0.05)。出血灶主要位于生发基质-脑室、大小脑半球(分别为33、34、25个),SWI较常规MRI及DWI显示更多这些部位的出血灶(均P<0.05);常规MRI及SWI较DWI更敏感地显示蛛网膜下腔出血及硬膜下出血(P<0.05),但常规MRI与SWI相仿。早产儿出血灶总数及生发基质-脑室出血灶数目均多于足月儿(P<0.05),而其他部位出血灶数目差异无统计学意义(P>0.05)。结论 SWI对新生儿颅内出血检出优于常规MRI及DWI,但各序列显示不同部位颅内出血差异存在统计学意义,对怀疑有颅内出血的新生儿,应行上述序列检查以综合判断有无颅内出血及出血数目。上述结果可为新生儿颅内出血的临床诊断、治疗及预后评估提供重要依据。
Objective To investigate the diagnostic value of magnetic susceptibility weighted imaging (SWI) in neonatal intracranial hemorrhage and to compare the differences between preterm and term infants. Methods One hundred and fifteen neonates suspected of brain injury underwent routine MRI, DWI and SWI examinations. The intracranial hemorrhage was determined with or without intracranial hemorrhage. The number of hemorrhagic foci in each series was recorded. The detection rate, distribution and lesions of intracranial hemorrhage were compared among the three methods The difference between the number of intracranial hemorrhage and the number of lesions detected in preterm children and term infants was compared. Results The positive rate of intracranial hemorrhage in SWI was higher than that of conventional MRI and DWI in 115 neonates (the detection rates were 32.2%, 26.1%, 12.2%, P <0.05) ). Thirty-seven newborn infants with intracranial hemorrhage showed 66,33 and 125 intracranial hemorrhagic lesions detected by routine MRI, DWI and SWI respectively. The SWI showed more hematogenous lesions than conventional MRI and DWI (all P <0.05). Hemorrhagic lesions mainly located in the germinal matrix - the ventricle, the cerebral hemispheres (33, 34, 25, respectively), and the SWI showed more hemorrhagic lesions in these sites than conventional MRI and DWI (all P <0.05) Showed subarachnoid hemorrhage and subdural hemorrhage more sensitively (P <0.05), but conventional MRI was similar to SWI. The number of hemorrhagic lesions in preterm infants and the number of germinal matrix-ventricular hemorrhagic foci were more than those in full-term infants (P <0.05), while there were no significant differences in the number of hemorrhagic lesions in other sites (P> 0.05). Conclusion SWI is better than routine MRI and DWI in detection of intracranial hemorrhage in neonates, but there are significant differences in intracranial hemorrhage between different sequences in different sequences. For newborns suspected of having intracranial hemorrhage, the above sequence should be used to determine whether there is cranial The number of internal bleeding and bleeding. The above results may provide an important basis for the clinical diagnosis, treatment and prognosis evaluation of neonatal intracranial hemorrhage.