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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

2017-12-30 中国医师协会新生儿科医师分会 中国当代儿科杂志.2017,19(12):1225-1233.

新生儿缺氧缺血性脑病磁共振诊断损伤类型

新生儿缺氧缺血性脑病（HIE）有比较统一的临床诊断与分度标准，但是符合相同诊断标准的窒息所致HIE 的临床表现、神经病理损伤类型有很大差异。磁共振成像（MRI）能很好地呈现HIE 损伤类型、损伤进程，且与其远期神经发育结局密切相关，但不同MRI 检查序列所反映的损伤表现可能不尽相同。弥散加权序列适宜的检查时间为出生后2~4 d，常规序列为出生后的4~8 d。HIE 的MRI 主要损伤类型有丘脑基底

中文标题：

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

发布机构：

中国医师协会新生儿科医师分会

发布日期：

2017-12-30

简要介绍：

新生儿缺氧缺血性脑病（HIE）有比较统一的临床诊断与分度标准，但是符合相同诊断标准的窒息所致HIE 的临床表现、神经病理损伤类型有很大差异。磁共振成像（MRI）能很好地呈现HIE 损伤类型、损伤进程，且与其远期神经发育结局密切相关，但不同MRI 检查序列所反映的损伤表现可能不尽相同。弥散加权序列适宜的检查时间为出生后2~4 d，常规序列为出生后的4~8 d。HIE 的MRI 主要损伤类型有丘脑基底节+内囊后肢损伤、分水岭样损伤累及皮层和皮层下白质、局灶- 多灶性微小性白质损伤，以及广泛全脑性损伤。严重的急性产时窒息易导致深部灰质损伤（丘脑基底节），也可累及脑干，锥体束是最易受累的白质纤维束，而反复间断性缺氧缺血以及伴有感染、低血糖等易导致分水岭区和深部白质损伤。但上述损伤类型有时很难明确区分，而是以某一类型为主，并非所有HIE 都有特征性的MRI 表现。

 

拓展指南：与新生儿相关指南：

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    2021-08-27 ms5000000616803644

    谢谢，学习下

    0

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    2020-11-15 angelxuqun

    学习一下

    0

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    2018-01-16 竹颜

    很不错的文章.值得一看.受益匪浅.

    0

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    2018-01-09 天涯183

    非常好的文章.学习了

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1011981, encodeId=d45f101198135, content=谢谢，学习下 , beContent=null, objectType=guider, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=b7f65586559, createdName=ms5000000616803644, createdTime=Fri Aug 27 10:21:55 CST 2021, time=2021-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=899320, encodeId=ce5489932073, content=学习一下, beContent=null, objectType=guider, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200813/b1abcd13be9b46ccbdae129de175993e/99752621e5834568ace14ab208cba6cc.jpg, createdBy=586c2614751, createdName=angelxuqun, createdTime=Sun Nov 15 15:08:35 CST 2020, time=2020-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=278960, encodeId=84792e8960b4, content=很不错的文章.值得一看.受益匪浅., beContent=null, objectType=guider, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/A255C84C7CC905B7A536F1089C7CFA96/100, createdBy=526a2034359, createdName=竹颜, createdTime=Tue Jan 16 07:23:32 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=276898, encodeId=4cf42e689872, content=非常好的文章.学习了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Tue Jan 09 13:18:26 CST 2018, time=2018-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=276710, encodeId=44612e6710e2, content=学习了.很有用哦, beContent=null, objectType=guider, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/12/04/814fa39d83beb92dc26692a86b3fa1a6.jpg, createdBy=05ed2214676, createdName=Jessie2443, createdTime=Mon Jan 08 22:08:37 CST 2018, time=2018-01-08, status=1, ipAttribution=)]
    2018-01-08 Jessie2443

    学习了.很有用哦

    0