• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Magnetic resonance spectroscopy predicts outcomes for children with nonaccidental trauma.
【24h】

Magnetic resonance spectroscopy predicts outcomes for children with nonaccidental trauma.

机译：磁共振波谱可预测非意外创伤儿童的预后。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

OBJECTIVE: We evaluated proton magnetic resonance spectroscopic imaging (MRSI) findings for children with traumatic brain injury attributable to nonaccidental trauma (NAT) early after injury, to determine whether brain metabolite changes predicted outcomes. METHODS: Proton MRSI (1.5 T) was performed (mean: 5 days after injury [range: 1-30 days]) through the level of the corpus callosum for 90 children with confirmed NAT. Regional N-acetylaspartate/total creatine, N-acetylaspartate/total choline, and choline/creatine ratios and the presence of lactate were measured. Data on long-term outcomes defined at > or =6 months were collected for 44 of 90 infants. We grouped patients into good (normal, mild disability, or moderate disability; n = 32) and poor (severe disability, vegetative state, or dead; n = 12) outcome groups. RESULTS: We found that N-acetylaspartate/creatine and N-acetylaspartate/choline ratios (mean total, corpus callosum, and frontal white matter) were significantly decreased in patients with poor outcomes (P < .001). A logistic regression model using age, initial Glasgow Coma Scale score, presence of retinal hemorrhage, lactate on MRSI scans, and mean total N-acetylaspartate/creatine ratio predicted outcomes accurately in 100% of cases. CONCLUSIONS: Reduced N-acetylaspartate levels (ie, neuronal loss/dysfunction) and elevated lactate levels (altered energy metabolism) correlated with poor neurologic outcomes for infants with NAT. Elevated lactate levels may reflect primary or secondary hypoxic-ischemic injury, which may occur with NAT. Our data suggest that MRSI performed early after injury can be used for long-term prognosis.
机译：目的：我们评估了质子磁共振波谱成像（MRSI）对创伤后早期由非意外创伤（NAT）引起的颅脑外伤儿童的发现，以确定脑代谢物是否改变了预测的结果。方法：对90例确诊为NAT的患儿，通过call体水平进行质子MRSI（1.5 T）试验（平均：受伤后5天[范围：1-30天]）。测量了区域N-乙酰天门冬氨酸/总肌酸，N-乙酰天门冬氨酸/总胆碱，胆碱/肌酸的比率以及乳酸的存在。收集了90例婴儿中≥6个月的长期结局数据。我们将患者分为良好（正常，轻度残疾或中度残疾; n = 32）和较差（严重残疾，植物状态或死亡; n = 12）两组。结果：我们发现，预后较差的患者中N-乙酰天门冬氨酸/肌酸和N-乙酰天冬氨酸/胆碱的比率（平均总数，call体和额叶白质）显着降低（P <.001）。使用年龄，初始格拉斯哥昏迷量表评分，视网膜出血的存在，MRSI扫描上的乳酸以及平均N-乙酰天冬氨酸/肌酸总比的对数回归模型可以准确地预测100％病例的预后。结论：NAT婴儿的N-乙酰天门冬氨酸水平降低（即神经元丧失/功能障碍）和乳酸水平升高（能量代谢改变）与不良的神经学预后相关。乳酸水平升高可能反映了NAT可能引起的原发性或继发性缺氧缺血性损伤。我们的数据表明，在受伤后早期进行MRSI可用于长期预后。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号