【摘要】 目的 探讨缺氧缺血性脑病(HIE)的临床与MR表现。方法 对21例HIE患者的临床、头颅MR、MR氢波谱(1H-MRS)、弥散张量成像(DTI)结果进行回顾性分析。结果 本组临床主要表现为意识障碍、锥体外系症状、锥体束损害、智能障碍及精神症状等。MR病灶均位于脑白质和(或)基底节区。10例1H-MRS中病灶区胆碱类化合物(Cho)峰均升高，7例N-乙酰天门冬氨酸(NAA)峰降低，6例乳酸(Lac)峰增高或呈双峰。8例DTI中均示病灶区脑白质纤维束形态变细消融。结论 HIE患者行MR及功能MR检查可以准确评估脑组织受损程度和范围，有利于病情分析和判断预后。

    【关键词】 缺氧缺血性脑病；MR氢波谱；弥散张量成像

    The MRI and clinical features of hypoxic-ischemic encephalopathy

    WANG Ling-ling,SHI Jing-ping,LIU Wen,et al.

    Department of Neurology,Brain Hospital Affiliated to Nanjing Medical University,Nanjing 210029,China

    【Abstract】 Objective To study the MRI and clinical features of hypoxic-ischemic encephalopathy.Methods The clinical features as well as the results of brain MRI,1H-MRS and DTI in 21 patients with hypoxic-ischemic encephalopathy were reviewed.Results The main clinical features of these 21 cases includes conscious disturbance,extrapyramidal symptoms,pyramidal symptoms,hypophrenia and psychiatric symptom.Brain MRI examinations revealed abnormal signals in white matter and/or basal ganglia regions.Ten patients examed by 1H-MRS showed an elevated Cho peak in the lesion area,among whom a lowered NAA peak was found in 7 cases while an elevated Lac level or a double peak in 6 cases.All the 8 patients examed by DTI showed an ablation of white matter fibrotracts.Conclusion Brain MRI and functional MRI examinations may be used to ascertain the severity and extent of the lesion accurately,which may allow a better understanding of hypoxic-ischemic encephalopathy and judgement of prognosis. ......