目的探讨早产儿脑损伤的危险因素及核磁共振成像(magnetic resonance imaging,MRI)对早产儿脑损伤的诊断价值。方法收集作者医院2014-10/2016-03月131例早产儿的头颅MRI检查资料及相关临床资料。采用McNemar检验比较不同MRI序列诊断缺氧缺血性脑损伤的敏感性。采用χ~2检验比较不同胎龄早产儿发生脑损伤的患病率,采用二分类Logistic回归分析探讨早产儿脑损伤的临床相关危险因素。结果弥散加权成像(diffusion weighted imaging,DWI)序列诊断缺血性脑损伤的敏感性显著高于T1加权像(T1 weighted image,T1 WI)、T2加权像(T2weighted image,T2 WI),且差异具有统计学意义(P<0.05);早产儿脑损伤总患病率23.66%,胎龄越低患病率越高,不同胎龄组间比较差异具有统计学意义(P<0.01),但不同脑损伤类型中仅脑室周围-脑室内出血患病率在不同胎龄早产儿间存在统计学差异(P<0.01)。机械通气、复苏抢救史、低钠血症、顺产是早产儿出血性脑损伤的危险因素,低Appgar评分(5分)、母孕期感染、母孕期糖尿病是早产儿缺氧缺血性脑损伤的危险因素。结论 T1 WI-T2 WI与DWI相结合的MRI检查方式可以提高早产儿脑损伤检出敏感性,早产儿顺产、需要复苏抢救,产后需要机械通气、发生低钠血症出现脑出血的风险更大;而分娩前母亲感染、患糖尿病,以及分娩时窒息则可能发生缺氧缺血性脑损伤。 Objective To investigate the risk factors of brain injury in premature infants and the diagnostic value of magnetic resonance imaging (MRI) in premature infants with brain injury. Methods The MRI data and related clinical data of 131 cases of preterm infants from the author hospital from 2014 to October / 2016 to March were collected. The McNemar test was used to compare the sensitivity of different MRI sequences in the diagnosis of hypoxic-ischemic brain damage. The prevalence of brain injury in preterm infants with different gestational ages was compared by χ ~ 2 test. Logistic regression analysis was used to investigate the clinically relevant risk factors of premature infants with brain injury. Results Diffusion weighted imaging (DWI) was significantly more effective in diagnosing ischemic brain injury than T1 weighted images (T1 WI) and T2 weighted images (T2 WI) (P <0.05). The total prevalence of brain injury in preterm infants was 23.66%, the lower the gestational age was, the higher the prevalence was (P <0.01), but the difference was statistically significant The prevalence of periventricular-ventricular hemorrhage in the type of injury was statistically different between preterm infants of different gestational ages (P <0.01). Mechanical ventilation, resuscitation and salvage history, hyponatremia, and spontaneous labor are the risk factors of hemorrhagic brain injury in preterm infants. The low Appgar score (5 points), maternal pregnancy, and gestational diabetes mellitus are hypoxic-ischemic brain damage in preterm infants Risk factors. Conclusion The combination of T1WI-T2WI and DWI can improve the detection sensitivity of brain injury in premature infants. Premature delivery of abortion requires resuscitation and rescue. After delivery, mechanical ventilation is needed and the risk of cerebral hemorrhage in hyponatremia is greater ; Mother’s infection before delivery, suffering from diabetes, and asphyxia during childbirth may occur hypoxic-ischemic brain damage.