Analysis of magnetic resonance imaging (MRI) morphometry and cerebral blood flow in patients with hypoxic-ischemic encephalopathy
Analysis of magnetic resonance imaging (MRI) morphometry and cerebral blood flow in patients with hypoxic-ischemic encephalopathy
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DOI：
10.1016/j.jocn.2002.12.006
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发表时间：
2004-05-01
影响因子：
2
通讯作者：
Maekawa, T
中科院分区：
文献类型：
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作者：
Nogami, K;Fujii, M;Maekawa, T
本研究的目的是分析缺氧缺血性脑病患者的磁共振成像(MRI)形态测量和脑血流量(CBF)，并确定这些测量用于预测脑预后的可行性。受试者是26名有心肺复苏病史的患者，他们后来发展成脑病。我们在亚急性期(8-20天)使用稳定的氙气计算机断层扫描(Xe-CT)和磁共振图像检查脑血流。在MRI研究中，基底节出现了三种信号变化模式。第一种模式，在T1加权像(T1W1)和T2加权像(T2W1)上均可观察到等信号区，在4名患者中观察到了良好的结果。第二种类型，T1W1等或低信号区和T2W1高信号区，6例预后良好的患者和3例预后较差的患者观察到。第三种类型，在T1W1和T2WI上均有明显的高信号区，13例预后较差的患者观察到。预后良好患者大脑半球CBF为38.9±-4.6(SD)ml/100g/min，预后不良患者为25.3±4.3ml/100g/min(P<；0.01)。应用乙酰唑胺后，预后良好患者的脑血流量增加为13.3±3.4ml/100g/min，预后不良患者为6.8±5.6ml/100g/min(P<；0.05)。T1WI表现为基底节高信号病变，低半球脑血流量(
The aim of this study was to analyze magnetic resonance imaging (MRI) morphometry and cerebral blood flow (CBF) in patients with hypoxic-ischemic encephalopathy, and determine the viability of such measurements for predicting cerebral outcome. The subjects were 26 patients with histories of cardiopulmonary resuscitation who had subsequently developed encephalopathy. We examined the CBF using stable xenon-computed tomography (Xe-CT) and MR images in the subacute period (8-20 days). Three signal-change patterns in the basal ganglia emerged in the MRI study. The first pattern, isointense areas evident in both the T1-weighted image (T1Wl) and the T2-weighted image (T2Wl), was observed in four patients with favorable outcomes. The second pattern, iso- or hypointense areas evident in the T1Wl and hyperintense areas evident in the T2Wl, was observed in six patients with favorable outcomes and three patients with poor outcomes. The third pattern, hyperintense areas evident in both the T1Wl and T2WI, was observed in 13 patients with poor outcomes. Hemispheric CBFs were 38.9 +/- 4.6 (mean (SD)) ml/100 g/min in patients with favorable outcomes and 25.3 +/- 4.3 ml/100 g/min in patients with poor outcomes (P < 0.01). The CBF increase after acetazolamide administration was 13.3 +/- 3.4 ml/100 g/min in patients with favorable outcomes and 6.8 +/- 5.6 ml/100 g/ min in patients with poor outcomes (P < 0.05). The presence of hyperintense lesions in the basal ganglia in T1WI, low hemispheric CBF (