Hypoxia-ischemic encephalopathy in full-term neonate: correlation proton MR spectroscopy with MR imaging
Hypoxia-ischemic encephalopathy in full-term neonate: correlation proton MR spectroscopy with MR imaging
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DOI：
10.1016/s0720-048x(02)00021-9
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发表时间：
2003-02-01
影响因子：
3.3
通讯作者：
Mao, J
中科院分区：
文献类型：
--
作者：
Fan, GG;Wu, ZH;Mao, J
简介：目的探讨H-1磁共振波谱（HMRS）-H-1在足月新生儿缺氧缺血性脑病（HIE）诊断中的价值。材料与方法：选择临床诊断为HIE的足月新生儿38例，行MRI及（HMRS）-H-1检查。年龄范围为7至17天，中位年龄为8.2天。其中26例在6个月及以后随访和/或复查MRI。8例健康新生儿，没有出生窒息的证据，也进行了1HMRS的比较。常规MR检查采用SE序列，1HMRS检查采用点分辨波谱序列。代谢产物包括N-乙酰天冬氨酸（NAA）、胆碱化合物（CHO）、肌酸化合物（CR）、肌醇（MI）、乳酸（LAC）、谷氨酸和谷氨酰胺（Glu-Gln）。结果如下：2例NAA峰下降，26例LAC峰升高，呈典型双峰状，9例Glu-Gln峰升高，呈锯齿状。11例CR峰降低，7例MI峰升高。12例LAC/CR比值<0.5的患者MRI显示为轻度病变，15例LAC/ CR比值在0.5 ~ 1.5之间的患者MRI显示为轻中度病变。而在LAC/CR比值大于1.5的I/I病例中，MRI显示9例重度病变和2例中度病变。38例中26例随访和/或6个月后复查MRI，其中12例有后遗症。其中LAC/CR比值大于1.5的9例中有8例出现后遗症（占88.89%）。结论：1HMRS对HIE的诊断及预后判断有重要价值。(C)2002爱思唯尔科学爱尔兰有限公司保留所有权利。
Introduction: To evaluate H-1 Magnetic Resonance Spectroscopy ((HMRS)-H-1) in the diagnosis of hypoxia-ischemic encephalopathy (HIE) of full-term neonates correlated with Magnetic Resonance Imaging (MRI). Materials and methods: Thirty-eight cases of fullterm neonates diagnosed as HIE clinically were selected to perform MRI and (HMRS)-H-1 examination. The ages ranged from 7 to 17 days, with median age of 8.2 days. In which, 26 cases were followed up and/or MRI reexamined at 6 months of age or later. Eight healthy neonates, with no evidence of birth asphyxia, also underwent 1HMRS for comparison. SE sequences were used for routine MR examination; point resolved spectroscopy sequence was required for 1HMRS. The metabolites in the spectra includes: N-acetylaspartate (NAA), choline compounds (CHO), creatine compounds (CR), myo-inositol (MI), lactate (LAC), glutamate and glutamine (Glu-Gln). Results: The peaks of NAA were fall in two cases; the peaks of LAC, which were elevated, appeared as typical double-peaks appearance in 26 cases; the peaks of Glu-Gln, which were also elevated, appeared as zigzag appearance in nine cases. The peaks of CR were decreased in 11 cases, while those of MI were increased in seven cases. Mild type of lesions was present on MRI in 12 cases whose LAC/CR ratio lower than 0.5; mild and moderate types of lesions were present in 15 cases whose LAC/ CR ratio between 0.5 and 1.5. Whereas, nine cases of severe lesions and two cases of moderate lesions were present on MRI in I I cases whose LAC/CR ratio greater than 1.5. Twenty-six of 38 cases were followed up and/or MRI reexamined after 6 months, in which, sequelae were present in 12 cases. Among them, eight cases of sequelae in nine cases whose LAC/CR ratio greater than 1.5 were present (account for 88.89%). Conclusion: 1HMRS plays an important role to diagnose and predict outcome of HIE. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.