Value On The Application Of Diffusion Weighted Imaging In The Early Diagnosis Of Full-term Neonatal HIE

ObjectiveTo explore the value of diffusion weighted imaging(DWI)in the early diagnosis of full-term neonatal hypoxic-ischemic encephalopathy and explore the best time window of DWI examination for the clinical suspicious full-term HIE.MethodsSixty-four full-term neonatal cases diagnosed as hypoxic-ischemic encephalopathy(HIE)admitted by the Neonatal Department of the Affiliated Hospital of Taishan medical college from October 2014 to November 2016 were slected as HIE group,among them,19 cases in mild group,45 cases in moderate-severe group.Another 65 cases normal full-term newborns without asphyxia history were slected as control group.All the research object conducted routine MRI(T1WI,T2 WI,T2FLAIR)and DWI examination.Meanwhile,ADC values of 7 regions of measurement were measured and analysised the difference of ADC values between each group.ResultsMild HIE lesions were only found in the cortex and subcortical white matter,Moderate-severe HIE lesions were found frequently in deep brain white matter,while,Basal ganglia,thalamus and corona radiate are relatively rare.Ninety-two lesions were detected in deep brain white matter of moderate-severe HIE,the detection number of lesions by DWI had significantly statistical difference compared with routine MRI(P<0.01),among them,the detection rate for frontal and parietal deep white matter,lateral ventricle triangle white matter,splenium of corpus callosum,posterior limb of intemal capsule,temporal occipital white matter had had significantly statistical difference than routine MRI(P<0.01),while,the detection rate for Basal ganglia,thalamus,corona radiate had no statistical difference than routine MRI(P>0.05).Receiving DWI examination within 5 days after birth,the detection rate for lesions had best significantly statistical difference than routine MRI(P<0.01),while,receiving DWI examination 10 days later,the detection rate for lesions had no statistical difference than routine MRI(P>0.05).The average ADC of deep white matter around the lateral ventricle before and after angle in normal group and HIE group were higher than the central white matter.The ADC values of all regions of measurement in mild HIE group had no statistical difference than normal group(P>0.05),while,The ADC values of all regions of measurement in moderatesevere HIE group had significantly statistical difference than normal group and mild HIE group(P<0.01).ConclusionWith the progress of the disease,the lesions scope were different in the full-term HIE.DWI had much more value than conventional MRI in the early diagnosis of moderatesevere HIE.Within 5 days after birth maybe the best time window in receiving DWI examination for the clinical suspicious full-term HIE,while,receiving examination 10 days later after birth,DWI may have no obvious advantage.The average ADC of around deep white matter in normal group were higher than the central white matter.the ADC values of all lesions in moderate-severe HIE group had significantly statistical difference than normal group and mild HIE group,while,its in mild HIE group had no statistical difference than those in normal group.ADC values can not only evaluate the degree of myelination of brain white matter in the normal full-term newborn,but also to analyze the degree of cerebral injury of HIE.