Application of MRI-DWI combined with blood gas analysis for umbilical cord blood in predicting the prognosis of neonates with hypoxic-ischemic encephalopathy
10.3969/j.issn.1672-8270.2025.02.013
- VernacularTitle:MRI弥散加权成像联合脐血血气分析在缺氧缺血性脑病新生儿预后预测中的研究
- Author:
Haitian WANG
1
;
Lan WANG
;
Wei QIN
Author Information
1. 青岛市第八人民医院放射科 青岛 266121
- Publication Type:Journal Article
- Keywords:
Magnetic resonance imaging-diffusion weighted imaging(MRI-DWI);
Blood gas analysis of umbilical cord blood;
Hypoxic-ischemic encephalopathy(HIE);
Influencing factor;
Prognosis prediction
- From:
China Medical Equipment
2025;22(2):70-76
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the application of magnetic resonance imaging-diffusion weighted imaging(MRI-DWI)combined with blood gas analysis for umbilical cord blood in predicting the prognosis of neonates with hypoxic-ischemic encephalopathy(HIE).Methods:A retrospective analysis was conducted on the baseline data of 200 HIE neonates who underwent MRI-DWI combined with blood gas testing for umbilical cord blood at Qingdao Eighth People's Hospital from January 2021 to May 2024.The neonates were divided into two groups based on their prognosis:poor prognosis group(61 cases)and good prognosis group(139 cases).The baseline data with significant differences between the two groups were included in the logistic regression model to analyze the factors of affecting the occurrence of poor prognosis.The predictive efficacy of the influence factors on the occurrence of poor prognosis was analyzed by using the receiver operating characteristic(ROC)curve.Results:There were statistically significant differences in the apparent diffusion coefficient(ADC)values of various regions(semioval center,caudate nucleus,lentiform nucleus,anterior limb of internal capsule,genu of internal capsule,and dorsal thalamus)and blood gas-related indicators of umbilical cord blood(pH value,oxygen partial pressure,carbon dioxide partial pressure,bicarbonate)between the two groups(t=-3.167,-4.929,-4.826,-4.489,2.648,-5.511,-5.048 and-5.829 and 2.311,-4.484,P<0.05).Multivariate logistic regression analysis showed that higher ADC values in the lentiform nucleus,anterior limb of internal capsule,genu of internal capsule,and dorsal thalamus,as well as higher pH values,oxygen partial pressure,and bicarbonate levels,were protective factors against poor prognosis of HIE neonates(OR=0.007,0.014,0.099,0.000,0.078,0.371,0.781,P<0.05).ROC curve analysis showed that the area under curve(AUC)values of the ADC values of the lentiform nucleus,anterior limb of internal capsule,genu of internal capsule and dorsal thalamus,pH value,oxygen partial pressure,bicarbonate,and combination of them were respectively 0.691,0.728,0.612,0.742,0.689,0.746,0.673 and 0.931.When the cut-off values were respectively 1.10,1.20,1.19,1.16,6.89,13.90 and 18.73,the sensitivities of the corresponding ADC value of the lentiform nucleus,anterior limb of internal capsule,genu of internal capsule and dorsal thalamus,pH value,oxygen partial pressure,bicarbonate were respectively 0.532,0.863,0.770,0.568,0.597,0.741 and 0.568,and the specificities of them were respectively 0.770,0.623,0.475,0.951,0.754,0.672,0.754.The sensitivity and specificity of the combined prediction were respectively 0.878 and 0.869.Conclusion:Higher ADC value of the lentiform nucleus,anterior limb of internal capsule,genu of internal capsule and dorsal thalamus,as well as higher pH value,higher oxygen partial pressure,and higher bicarbonate level,are protective factors against poor prognosis of HIE neonates.These indicators have a certain predictive value for poor prognosis of HIE neonates,and the combined prediction has higher predictive value,which is helpful to the clinical intervention and treatment.
