Early MRI findings and the evolution of neonatal hypoglycemic brain injury
10.3760/cma.j.issn.1673-4912.2014.05.002
- VernacularTitle:新生儿低血糖脑损伤早期MRI表现及其演变
- Author:
Yi ZHANG
;
Jian MAO
- Publication Type:Journal Article
- Keywords:
Hypoglycemia;
Brain injury;
Magnetic resonance imaging;
Neonate
- From:
Chinese Pediatric Emergency Medicine
2014;21(5):263-267
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the imaging features in neonates with hypoglycemic brain injury by early and serial MRI.Methods Neonates who were admitted to neonatal department from May 2005 to Jul 2013 received MRI and diffusion-weighted imaging(DWI) scan within 7 days after hypoglycemia.Fortynine neonates were diagnosed with hypoglycemic brain injury.Thirty-four neonates received second MRI scan between 2 ～3 weeks after hypoglycemia.Seven neonates received third MRI scan.Results All the 49 neonates showed hyperintensity on DWI in the regions of occipital and parietal lobe for the first MRI scan(mainly involved 33 cases).Six cases combined frontal lobe and temporal lobe.Ten cases presented widespread cortex and white matter involvement.All the cases presented hypointensity on DWI for the affected area,T1 and T2 weighted image signal changes were not obvious.Some cases presented deep white matter and gray matter injury.Thirty-four cases received second MRI scan between 2 ～3 weeks after hypoglycemia,20 presented hypointensity on DWI,hypointensity on T1 weighted image and hyperintensity on T2 weighted image.Eleven cases with normal signals,and the other 3 were absorbing.Seven cases received third MRI scan,appeared encephalomalacia,myelin retardation,white matter volume decreased,hypoplasia of corpus callosum.The more severe the clinical symptoms was,the more severe the degree of brain injury showed.Conclusion Cerebral occipital and parietal regions are the most vulnerable in neonatal hypoglycemic brain injury.Early DWI for the imaging diagnosis of hypoglycemic brain injury should be taken within one week after hypoglycemia.Mild injury is recoverable,but severe would chang into necrosis and encephalomalacia.Some combined deep white and gray matter injury might related to hypoxia and ischemia.
