Susceptibility Weighted Imaging In Combination With Diffusion Weighted Imaging In The Diagnosis Of Neonatal Intracranial Hemorrhage

Objective: To study the value of susceptibility weighted imaging in combination with the diffusion weighted imaging in the diagnosis of neonatal intracranial hemorrhage or with white matter damage.Materials and Methods: A study was conducted including 108 neonates who were suspected neonatal intracranial hemorrhage,71 males,37 females;79 cases of full-term infants,29 preterm infants;Birth weight of the minimum value of 1530 g,the maximum value of 5600 g,x ±S=3103±693 g;Patients aged from one day to 28 days old,x ±S=8.090±5.452 days,Which was less than or equal to 7 days in 65 cases,33 cases of8~14 days,15~28 days in 10 cases.All MR examinations were performed at 1.5 Tesla unit including conventional MR(T1WI,T2 WI,T2 Flair),SWI and DWI.The detecting rate,distribution and number of intracranial hemorrhage were compared among SWI and conventional MRI,the number of cases and the number of lesions in the white matter lesions in each sequence were compared and counted.Results:(1).Detection of intracranial hemorrhage in neonates with SWI and conventional MR sequences: ?Among108 neonates suspected intracranial hemorrhage,81 cases were found neonatal intracranial hemorrhage in SWI and 41 cases were found in T1 WI,21 cases in T2 WI,22in T2 Flair.Two cases of premature infants with cerebral hemorrhage and hydrocephalus.In addition,there were 20 cases of intracranial hemorrhage were detected by SWI sequence which were showed negative on conventional MRI sequence.? 276 hemorrhagic lesions were detected on SWI images,among them,there were 97 subependymal hemorrhage/intraventricular hemorrhage(SHE/IVH),12 intraparenchymal hemorrhage(IPH),77 intracerebellar hemorrhage(ICEH),81 subdural hemorrhage(SDH)and 9 subarachnoid hemorrhage(SAH);114 lesions revealed on T1 WI,among them,there were 45 SHE/IVH,5 IPH,16 ICEH,45 SDH,3 SAH;77 lesions on T2 WI,they included44 SHE/IVH,3 IPH,13 ICEH,15 SDH,2 SAH;41 lesions on T2 Flair,they included 24SHE/IVH,6 IPH,1 ICEH,7 SDH,2 SAH.The detection rate of SWI was significantly higher than conventional MRI sequences(P<0.05).The hemorrhagic lesions detected by SWI were significantly higher than those of T1 WI,T2WI and T2 Flair(Z value was 36.084,35.383,39.278,the corresponding P value was 0.001,0.007 and 0.027).(2)The detection of white matter damage by DWI combined with SWI and conventional MRI sequences: Intracranial hemorrhage with white matter damage in 17 cases,barely white matter injury in 13 cases,among 30 white matter damage cases,DWI found 116 high signal lesions,the corresponding area SWI showed equal signal or high signal,T1 WI images showed high signal in 74 lesions,slightly low signal in 18 lesions and equal signal in 24 lesions,1 cases,2 lesions showed high signal in T1 WI,while DWI was equal signal;T2WI sequences showed high signal in 33 lesions,slightly low signal in 15 lesions and equal signal in 68 lesions,T2 Flair sequences showed high signal in 62 lesions and equal signal in 54 lesions.The detection rate of DWI was significantly higher than conventional MR sequences(x2=11.448,p=0.010).Among 74 punctate white matter lesions,T1 WI for high signal,T2 WI for equal or low signal,in SWI sequence 68 lesions were equal signa,6were slightly higher signal.Conclusion : SWI sequence has more sensitivity than conventional sequences in detecting the intracranial hemorrhage of neonate.Conventional MRI combined with SWI is more helpful to improve the diagnostic rate of the neonatal cerebral hemorrhage or cerebral hemorrhage with punctate white matter lesions,While DWI has more predominant advantage in early stage of white matter lesions.