新生儿缺氧缺血性脑损伤的磁共振成像:观点的演变和发展前景

P. A. Romanov, P. L. Sokolov, A. G. Prityko, N. V. Chebanenko
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摘要

目的:在研究大量现有资料的基础上,建立磁共振成像(MRI)在新生儿缺氧缺血性脑病变中的应用思路,介绍现有的研究算法、分类、技术范围及其在命名病理中的信息含量。要点。核磁共振成像长期以来一直是神经儿科医院的常见做法。迄今为止,这种检查方法对围产期缺氧缺血性脑病变的诊断具有绝对意义。此外,MRI数据有助于客观化治疗干预的有效性,并预测围产期脑损伤儿童的进一步发展。新生儿缺氧缺血性脑损伤的MRI变化有几种分类。这些分类对儿童大脑初始缺氧缺血性变化有不同程度的敏感性,但根据“脑室周围白质-皮层下神经节和丘脑-半球和大脑皮层皮层下结构”的方案,我们可以在形态学方面大致表征它们的动态形成过程。因此,缺氧缺血性病变的靶结构使我们能够确定其主要模式:神经元结构病变、白细胞病变及其组合。结论。MRI现象作为发育病理学预测指标的研究表明,细节的增加增加了预后的准确性。然而,现有的数据目前不允许我们形成一个空间模型的发展缺氧缺血性变化的新生儿的大脑。似乎有必要根据缺血过程影响的时间和强度来创建这样一个模型。这将允许发展围产期脑病的形态学和病理生理学分类。关键词:磁共振成像,缺氧缺血,缺氧缺血性脑损伤,新生儿,脑瘫
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Magnetic Resonance Imaging in Hypoxic-Ischemic Brain Lesions in Newborns: Evolution of Views and Development Prospects
Aim: Based on the study of a large amount of available information, to create an idea of the use of magnetic resonance imaging (MRI) in hypoxic-ischemic brain lesions in newborns, to present the available research algorithms, classifications, the scope of the technique and its information content in the named pathology. Key points. MRI has long been a common practice in a neuropediatric hospital. To date, examination by this method has absolute significance in the diagnosis of perinatal hypoxic-ischemic brain lesions. In addition, MRI data help to objectify the effectiveness of therapeutic interventions and predict the further development of a child with perinatal brain damage. There are several classifications of MRI changes in hypoxic-ischemic brain lesions in newborns. These classifications have varying degrees of sensitivity to the initial hypoxic-ischemic changes in the child's brain, however, allow us to roughly represent the process of their formation in dynamics in the morphological aspect according to the scheme “periventricular white matter — subcortical ganglia and thalamus — subcortical structures of the hemispheres and cerebral cortex”. Thus, the target structures of hypoxic ischemic lesions allow us to identify its main patterns: lesions of neuronal structures, leukopathy, and their combination. Conclusion. Studies of MRI phenomena as predictors of developmental pathology show that an increase in detail increases the accuracy of the prognosis. However, the available data do not currently allow us to form a spatial model for the development of hypoxic-ischemic changes in the brain of a newborn. It seems necessary to create such a model depending on the time and intensity of the impact of the ischemic process. This will allow developing a morphological and pathophysiological classification of perinatal encephalopathies. Keywords: magnetic resonance imaging, hypoxia-ischemia, hypoxic-ischemic brain damage, newborns, cerebral palsy.
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