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目的探讨磁共振成像技术T1WI与梯度回波T2*WI和磁敏感加权血管成像(SWAN)序列在新生儿颅内出血中的诊断价值。方法选择2012年12月至2014年1月北京军区总医院八一儿童医院新生儿重症监护病房收治并怀疑颅内出血的患儿行头颅磁共振(MR)检查。在T1WI检出高信号病灶时,加扫T2*WI或SWAN序列,表现为明显低信号的病灶认为是真实的出血灶,记录颅内出血病例数、出血灶的部位及数目。按照出血灶的位置,比较T1WI与T2*WI或SWAN序列对出血灶的检出能力。结果共入组58例,其中早产儿24例,足月儿34例。58例新生儿中经T2*WI和SWAN证实为新生儿颅内出血43例(74.1%),非颅内出血15例(25.9%)。43例颅内出血患儿中共检出出血灶508个,其中T1WI只检出283个出血灶,配对t检验证实T2*WI、SWAN对于出血灶的检出能力高于T1WI,差异有统计学意义(P<0.05)。结论 T2*WI或SWAN比常规MR在新生儿各种类型颅内出血灶的检出能力上具有明显优势,对诊断和鉴别颅内出血有意义。
Objective To investigate the diagnostic value of magnetic resonance imaging T1WI and gradient echo T2 * WI and magnetic resonance weighted angiography (SWAN) in neonatal intracranial hemorrhage. Methods From December 2012 to January 2014, patients with intracranial hemorrhage who had been admitted to the Children’s Hospital of Bayi Children’s Hospital of Beijing Military Region General Hospital were examined by head magnetic resonance (MR). T1WI detection of high signal lesions, plus scan T2 * WI or SWAN sequence, the performance was significantly low signal lesions that are real hemorrhage, record the number of intracranial hemorrhage, the location and number of hemorrhagic lesions. According to the location of the hemorrhage, we compared the detection ability of T1WI and T2 * WI or SWAN to the hemorrhage. Results A total of 58 patients were enrolled in the study, including 24 preterm infants and 34 full term infants. Among 58 newborns, 43 (74.1%) had newborn intracranial hemorrhage confirmed by T2 * WI and SWAN, and 15 (25.9%) had non-intracranial hemorrhage. A total of 508 hemorrhagic lesions were detected in 43 children with intracranial hemorrhage, of which 283 hemorrhagic lesions were detected on T1WI and T2 * WI on paired t-test. The detection of hemorrhagic lesions by SWAN was higher than that of T1WI (the difference was statistically significant ( P <0.05). Conclusion T2 * WI or SWAN has obvious advantages over conventional MR in the detection of various types of intracranial hemorrhage in neonates, which is significant for the diagnosis and differential diagnosis of intracranial hemorrhage.