中国当代儿科杂志2017，Vol.19Issue(12)：1225-1233,9.DOI:10.7499/j.issn.1008-8830.2017.12.001
新生儿缺氧缺血性脑病磁共振诊断与损伤类型的分类建议
Patterns of brain injury in neonatal hypoxic-ischemic encephalopathy on magnetic resonance imaging: recommendations on classification
摘要
Abstract
Although there are unified criteria for the clinical diagnosis and grading of neonatal hypoxic-ischemic encephalopathy (HIE), clinical features and neuropathological patterns vary considerably among the neonates with HIE due to birth asphyxia in the same classification. The patterns and progression of brain injury in HIE, which is closely associated with long-term neurodevelopment outcomes, can be well shown on magnetic resonance imaging (MRI), but different sequences may lead to different MRI findings at the same time. It is suggested that diffusion-weighted imaging sequence be selected at 2-4 days after birth, and the conventional MRI sequence at 4-8 days. The major patterns of brain injury in HIE on MRI are as follows: injury of the thalamus and basal ganglia and posterior limbs of the internal capsules; watershed injury involving the cortical and subcortical white matter; focal or multifocal minimal white matter injury; extensive whole brain injury. Severe acute birth asphyxia often leads to deep grey matter injury (thalamus and basal ganglia), and the brain stem may also be involved; the pyramidal tract is the most susceptible white matter fiber tract; repetitive or intermittent hypoxic-ischemic insults, with inflammation or hypoglycemia, usually cause injuries in the watershed area and deep white matter. It is worth noting that sometimes the pattern of brain injury among those described above cannot be determined exactly, but rather a predominant one is identified; not all cases of HIE have characteristic MRI findings.关键词
脑缺氧/缺氧缺血性脑病/磁共振成像/新生儿Key words
Cerebral hypoxia/Hypoxic-ischemic encephalopathy/Magnetic resonance imaging/Neonate引用本文复制引用
中国医师协会新生儿科医师分会..新生儿缺氧缺血性脑病磁共振诊断与损伤类型的分类建议[J].中国当代儿科杂志,2017,19(12):1225-1233,9.
