【作者】 黄万杰；

【导师】 薛辛东；

【作者基本信息】 中国医科大学 ， 儿科学， 2009， 硕士

【摘要】 目的磁共振成像是目前诊断新生儿脑梗死的金标准,然而常规磁共振对于新生儿脑梗死的早期显像并不敏感。为了早期诊断新生儿脑梗死,现探讨新生儿脑梗死(Neonatal cerebral infarction)患儿的早期临床表现及头部磁共振(MRI)成像学特征,包括常规MRI及弥散加权成像(DWI),并为早期诊断提供依据。方法回顾分析我院新生儿病房于2005年7月至2008年4月收治的16例新生儿脑梗死患儿临床资料、头部MRI检查(所有病例均于生后5天内行常规序列扫描后接受弥散加权序列扫描),其中5例于新生儿期(生后11天-17天)进行了第二次头部MRI检查。结果1、高危因素:产前8例(n=8,50%),产时9例(n=9,56.3%),产后0例(n=0,0%);临床表现:11例以惊厥发作为首发症状;2、MRI扫描结果:初期(5天内)病灶部位T1稍低信号,T2加权稍高信号,相同部位弥散加权影像均表现为高亮信号,且病灶边界清晰;再次扫描时(生后11天-17天)病灶部位T1低信号、T2高信号较前明显,相同部位弥散加权均表现为低信号。结论1、惊厥多为新生儿脑梗死的首发表现,发作次数少且程度轻;2、梗死早期DWI表现为高亮信号,继之常规MRI出现T1低信号、T2高信号,并随时间逐渐明显,尤以T2表现更为敏感。更多还原

【Abstract】 ObjectiveMagnetic resonance imaging(MRI) is the gold standard for the diagnosis of neonatal cerebral infarction(NCI) at present.Conventional MRI is not sensitive for the detection of stroke in the early stage.The aim of this study was to characterize the clinical presentations and imaging findings in conventional MRI and diffusion-weighted MR imaging(DWI) caused by NCI,which might be useful for the early diagnosis.MethodsConventional MRI,diffusion-weighted imaging and clinical data from 16 neonates with NCI were retrospectively reviewed.All cases underwent DWI in addition to conventional MR imaging(T1-weighted[T1W]and T2-weighted[T2W]) within first 5 days,5 of whom repeated the imaging at the age of 11 days to 17 days.Results1、Risk factors:antenatal risk factors(n=8);intranatal risk factors(n=9);postnatal risk factors(n=0).Clinical presentations:seizure was the first symptom in 11 neonates;2、early imaging(within 5 days):slightly hypointensity on T1W,slightly hyperintensity on T2W and significantly increased signal intensity with the clear boundary on DWI in the lesions;late imaging:Compared with the early imaging,more obviously hypointensity on T1W and hyperintensity on T2W,while hypointensity was shown on DWI.Conclusion1、Seizures characterized the low frequency and slight severity may be the first symptom for NCI.2、Firstly,it is the abnormal imaging finding that significantly increased signal intensity in the lesions was showed on DWI in the early stage;then hypointensity on T1W and hyperintensity on T2W,which are increasing abnormal over time particularly on T2W.更多还原