磁共振检查联合Gesell评分对脑损伤新生儿神经发育的预后评估价值

余晓婵, 魏祖健, 麦钻珍

湖南师范大学学报医学版 ›› 2024, Vol. 21 ›› Issue (6) : 114-118.

PDF(1983 KB)
PDF(1983 KB)
湖南师范大学学报医学版 ›› 2024, Vol. 21 ›› Issue (6) : 114-118.
临床医学

磁共振检查联合Gesell评分对脑损伤新生儿神经发育的预后评估价值

  • 余晓婵1, 魏祖健2, 麦钻珍1
作者信息 +

The Combined Value of MRI Examination and Gesell Score in Predicting the Prognosis of Neurodevelopment in Infants with Brain Injury

  • YU Xiaochan1, WEI Zujian2, MAI Zuanzhen1
Author information +
文章历史 +

摘要

目的:探讨磁共振检查(magnetic resonance imaging,MRI)联合Gesell评分对脑损伤新生儿神经发育的预后评估价值。方法:收集2022年7月—2023年7月在我院出生的脑损伤新生儿93例作为研究对象。根据头颅MRI结果将93例脑损伤新生儿分为轻度组(n=21),中度组(n=47),重度组(n=25)。根据Bayley婴幼儿发展量表,分为预后良好组65例和预后不良组28例。对比不同程度脑损伤新生儿MRI参数(T1值、T2值、DWI值)、Gesell评分,对比不同预后脑损伤新生儿的相关临床指标,并进行Pearson相关性分析、Logistic多因素分析及ROC曲线分析。结果:重度组患儿MRI参数(T1值、T2值、DWI值)均显著高于中度组和轻度组,重度组患儿Gesell评分显著低于中度组和轻度组。预后良好和预后不良组患儿性别、出生体重、1 min Apgar评分、分娩方式、孕期是否贫血无统计学差异;预后良好和预后不良组5 min Apgar评分、T1值、T2值、DWI值、Bayley评分及Gesell评分有统计学差异。经过Pearson相关性分析,脑损伤新生儿MRI参数(T1值、T2值、DWI值)与智力发育指数(mental development index,MDI)、运动发育指数(psychomotor development index,PDI)均呈负相关,Gesell评分与MDI、PDI均呈正相关。Logistic多因素分析结果显示,5 min Apgar评分、T1值、T2值、DWI值、Gesell评分是脑损伤新生儿神经发育预后的独立影响因素。ROC曲线显示,MRI参数联合Gesell评分预测脑损伤新生儿神经发育预后的AUC、敏感度均显著高于各指标单独诊断。结论:MRI参数联合Gesell评分对脑损伤新生儿神经发育的预后具有较高的预测价值。

Abstract

Objective To explore the prognostic value of magnetic resonance imaging (MRI) examination combined with Gesell score for neurodevelopment in infants with brain injury. Methods 93 infants with brain injury born in our hospital from July 2022 to July 2023 were selected as the research subjects. According to the results of cranial MRI, the 93 infants with brain injury were divided into mild group (n=21), moderate group (n=47), and severe group (n=25). According to the Bayley Infant Development Scale, they were divided into a good prognosis group of 65 cases and a poor prognosis group of 28 cases. Comparisons were made between different degrees of brain injury in infants (MRI parameters such as T1 value, T2 value, DWI value, and Gesell score), as well as clinical indicators of infants with different prognoses of brain injury, and Pearson correlation analysis, logistic multifactor analysis, and ROC curve analysis were conducted. Results The MRI parameters (T1 value, T2 value, DWI value) of children in the severe group were significantly higher than those in the moderate and mild groups, Gesell score in severe group was significantly lower than that in moderate group and mild group. There were no statistical differences in gender, birth weight, 1 min Apgar score, mode of delivery, and whether there was anemia during pregnancy between the good prognosis and poor prognosis groups; however, there were statistical differences in 5 min Apgar score, T1 value, T2 value, DWI value, Bayley score, and Gesell score between the good prognosis and poor prognosis groups. Pearson correlation analysis showed that the MRI parameters (T1 value, T2 value, DWI value) of infants with brain injury were negatively correlated with MDI and PDI, while the Gesell score was positively correlated with MDI and PDI (P<0.05). Logistic multifactor analysis results showed that 5 min Apgar score, T1 value, T2 value, DWI value, and Gesell score were independent influencing factors of the neurodevelopment prognosis of infants with brain injury. The ROC curve showed that the combined prediction of MRI parameters and Gesell score for the prognosis of neurodevelopment in infants with brain injury had significantly higher AUC and sensitivity than individual indicators. Conclusion The combined value of MRI parameters and Gesell score has a high predictive value for the prognosis of neurodevelopment in infants with brain injury.

关键词

磁共振 / Gesell发育量 / 脑损伤新生儿 / 神经发育 / 预后

Key words

magnetic resonance imaging / Gesell developmental scale / infants with brain injury / neurodevelopment / prognosis

引用本文

导出引用
余晓婵, 魏祖健, 麦钻珍. 磁共振检查联合Gesell评分对脑损伤新生儿神经发育的预后评估价值[J]. 湖南师范大学学报医学版. 2024, 21(6): 114-118
YU Xiaochan, WEI Zujian, MAI Zuanzhen. The Combined Value of MRI Examination and Gesell Score in Predicting the Prognosis of Neurodevelopment in Infants with Brain Injury[J]. Journal of Hunan Normal University(Medical Science). 2024, 21(6): 114-118
中图分类号: R722   

参考文献

[1] RAMSIE M, CHEUNG PY, LEE TF, et al.Comparison of various vasopressin doses to epinephrine during cardiopulmonary resuscitation in asphyxiated neonatal piglets[J]. Pediatr Res, 2023, 95(5): 1265-1272.
[2] THIVIYA S, STEVEN PM.Challenging Current Perspectives of Neonatal Hypoxic-Ischemic Encephalopathy: Is Encephalopathy Necessary?[J]. Neurology, 2024, 102(6): e209212-e209212.
[3] GRIESMAIER E, SCHREINER C, WINKLER I, et al.Association of aEEG and brain injury severity on MRI at term‐equivalent age in preterm infants[J]. Acta Paediatr, 2024, 113(2): 229-238.
[4] 黄亨烨, 于广军. 婴幼儿早期神经发育评估诊断量表的综述[J]. 中国儿童保健杂志, 2023, 31(2): 162-166.
[5] 中华医学会儿科学分会新生儿学组. 新生儿缺氧缺血性脑病诊断标准[J]. 中华儿科杂志, 2005, 43(8): 584.
[6] 吴亮. 基于ICF儿童发展和适应性行为测量工具的内容和心理测量特性研究[J]. 中国康复理论与实践, 2024, 30(3): 257-264.
[7] 刘超, 李诚善, 刘雅静. 0~3岁儿童心理行为发育预警征与Gesell发育评估一致性分析[J]. 中国儿童保健杂志, 2022, 30(10): 1141-1143.
[8] CIZMECI M, M MARTÍNEZ-BIARGE, COWAN F. The predictive role of brain magnetic resonance imaging in neonates with hypoxic-ischemic encephalopathy.[J]. Pediatr Res, 2023, 95(3): 601-602.
[9] PROIETTI J, BOYLAN G B, WALSH B H.Regional variability in therapeutic hypothermia eligibility criteria for neonatal hypoxic-ischemic encephalopathy[J]. Pediatr Res, 2024, 96(5): 1153-1161.
[10] 蔡婷婷, 林梅芳, 徐亚芬. 足月新生儿脑损伤早期超声的临床诊断价值[J]. 中国妇幼保健, 2022, 37(2): 356-359.
[11] 中国医师协会新生儿科医师分会, 中国当代儿科杂志编辑委员会. 新生儿颅脑磁共振检查临床实践的专家共识[J]. 中国当代儿科杂志, 2022, 24(1): 14-25.
[12] 侯明杰, 金美善, 李金成. 磁共振弥散加权成像联合磁敏感加权成像序列对于早期新生儿缺氧缺血性脑损伤的诊断价值[J]. 实用医技杂志, 2022, 29(2): 176-179.
[13] 徐梓毓, 颜妙如, 孙崎元, 等. MR-DWI直方图参数对新生儿缺氧缺血性脑病的诊断价值[J]. 川北医学院学报, 2023, 38(2): 195-198.
[14] 孟远翠, 范金超. MRI参数与缺血缺氧性脑病新生儿脑损伤程度及远期神经预后的关系[J]. 中国优生与遗传杂志, 2023, 31(2): 377-382.
[15] 杨晓云, 张林, 杨丽萍, 等. 弥散加权成像与振幅整合脑电图在评估脑白质损伤早产儿神经发育预后的研究[J]. 中国医学装备, 2022, 19(12): 71-75.
[16] 平东沛, 徐淑玲. 全身运动质量评估结合Gesell评估在64例高危早产儿运动发育中的研究[J]. 中国儿童保健杂志, 2020, 28(12): 1398-131400.
[17] 洪菲, 宋磊, 季菊花, 等. 磁共振波谱成像联合弥散加权成像在早产儿脑白质损伤诊断及预后评估中的应用[J]. 中国CT和MRI杂志, 2024, 22(2): 28-31.
[18] 吕攀攀, 高文婷, 赵娜, 等. 高危儿神经系统发育的评估: 236例报道[J]. 中国康复理论与实践, 2019, 25(6): 714-717.
[19] 张雨平. 婴幼儿脑损伤及其早期评估[J]. 中国儿童保健杂志, 2023, 31(2): 123-125.

基金

中山市医学科研项目“振幅整合脑电图联合神经行为测定对足月脑损伤新生儿进行早期评估及干预的效果评价”(2022A020742)

PDF(1983 KB)

Accesses

Citation

Detail

段落导航
相关文章

/