Changes and Clinical Significance of aEEG, MRI, Serum MMP and TIMP in Neonates with Intracranial Hemorrhage

doi:10.7517/issn.1674-0475.220827

Abstract

Abstract: This study investigated the characteristic changes of amplitude-integrated electroencephalography (aEEG), magnetic resonance imaging (MRI) and serum levels of matrix metalloproteinase 9 (MMP-9) and tissue inhibitor of metalloproteinase (TIMP-1) in neonates with intracranial hemorrhage, and its meaning. A total of 63 neonates with confirmed intracranial hemorrhage were selected as the hemorrhage group, and 80 healthy neonates during the same period were selected as the control group. In 63 neonates with intracranial hemorrhage, the detection rate of contralateral ventricular hemorrhage by SWI (50.79%) was higher than that of conventional MRI sequence (33.33%) (P<0.05). The proportion of children with continuous background activity in the continuous voltage and the proportion of children with sleep-wake cycles in the bleeding group were lower than those in the control group (P<0.05). The measured values of the lower boundary voltage of the QS phase and the lower boundary voltage of the AS phase of the children in the hemorrhage group were lower than those of the control group, and the measured values of the QS phase bandwidth and the AS phase bandwidth of the children in the hemorrhage group were higher than those of the control group (P<0.05). The serum levels of MMP-9 and TIMP-1 in the hemorrhage group were significantly higher than those in the control group (P<0.05). The serum levels of MMP-9 and TIMP-1 in the mall bleeding volume group, the medium bleeding volume group, and the large bleeding volume group gradually increased (P<0.05),and the difference between the two groups was statistically significant (P<0.05). SWI examination in neonates with intracranial hemorrhage can more accurately assess the bleeding site. aEEG has high diagnostic value for intracranial hemorrhage. Serum MMP-9 and TIMP-1 are related to the amount of intracranial hemorrhage. Comprehensive analysis of MRI, aEEG and serum MMP-9 and TIMP-1 levels is conducive to better clinical diagnosis of neonatal intracranial hemorrhage.

Key words: intracranial hemorrhage, amplitude-integrated EEG, magnetic resonance imaging, matrix metalloproteinase 9, tissue inhibitor of metalloproteinase

YAN Yonglei, LI Wen, LUO Bin, TANG Jing, REN Xinyue, FU Tianli, ZHAO Jing, YIN Meile, CHEN Liqi. Changes and Clinical Significance of aEEG, MRI, Serum MMP and TIMP in Neonates with Intracranial Hemorrhage[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(6): 1507-1512.

References

[1] Hausman-Kedem M, Malinger G, Modai S, et al. Monogenic causes of apparently idiopathic perinatal intracranial hemorrhage[J]. Annals of Neurology, 2021, 89(4):813-822.
[2] Viderman D, Ayapbergenov A, Abilman N, et al. Near-infrared spectroscopy for intracranial hemorrhage detection in traumatic brain injury patients:A systematic review[J]. The American Journal of Emergency Medicine, 2021, 50(8):758-764.
[3] 徐文慧, 尹冬琴, 李欢, 等. 振幅整合脑电图联合危重症评分对早产儿脑损伤的早期诊断价值评估[J]. 四川生理科学杂志, 2022, 44(4):734-736.
[4] 中华医学会儿科学分会围产专业委员会, 侯新琳, 程国强. 新生儿振幅整合脑电图临床应用专家共识[J]. 中华新生儿科杂志(中英文), 2019, 34(1):3-7.
[5] 黄会芝, 温晓红, 孙亚伟, 等. 振幅整合脑电图结合头颅MRI对窒息早产儿脑损伤的诊断及神经行为发育的预测[J]. 中华行为医学与脑科学杂志, 2021, 30(1):22-26.
[6] 王非洲, 李金华. 磁共振成像检查中磁敏感加权成像及弥散加权成像序列用于新生儿缺氧缺血性脑病的诊断[J]. 实用医学影像杂志, 2022, 23(3):258-260.
[7] 周娟, 张庆彦. 磁敏感加权成像在新生儿颅内出血中的诊断分析[J]. 实用医学影像杂志, 2020, 21(5):497-499.
[8] 罗震, 刘志博, 刘晶哲. MR常规序列联合SWI、DWI在新生儿颅内出血疾病中的诊断价值[J]. 中国CT和MRI杂志, 2022, 20(4):22-24, 114.
[9] Epstein K N, Kline-Fath B M, Zhang B, et al. Prenatal evaluation of intracranial hemorrhage on fetal MRI:A retrospective review[J]. American Journal of Neuroradiology, 2021, 42(12):2222-2228.
[10] 张晓娅, 杜春晖, 陈飞, 等. 新生儿颅内出血MRI影像学特征及其与临床特征和预后的关系[J]. 现代实用医学, 2021, 33(9):1202-1205.
[11] Navarro-Oviedo M, Muñoz-Arrondo R, Zandio B, et al. Circulating TIMP-1 is associated with hematoma volume in patients with spontaneous intracranial hemorrhage[J]. Scientific Reports, 2020, 10(1):e10329.
[12] Lattanzi S, Di Napoli M, Ricci S, et al. Matrix metalloproteinases in acute intracerebral hemorrhage[J]. Neurotherapeutics, 2020, 17(2):484-496.
[13] 胡亚美, 江载芳. 诸福棠实用儿科学[M]. 7版. 北京:人民卫生出版社, 2006.
[14] 俞秋雨, 方开峰, 韩路, 等. 颅脑超声与MRI检查应用于新生儿颅内出血诊断中的临床价值初探[J]. 中国CT和MRI杂志, 2020, 18(9):11-13.
[15] 宋振伟. 磁共振弥散加权成像联合磁敏感加权成像检查在脑出血急性期诊断中的应用价值研究[J]. 影像研究与医学应用, 2020, 4(10):85-86.
[16] 赵沁萍, 黄瑞岁, 刘春玉. 3.0T磁共振磁敏感加权成像对新生儿颅内出血的诊断价值[J]. 中国CT和MRI杂志, 2018, 16(4):17-18, 36.
[17] 陈新云. 炎症因子在大鼠脑缺血后MMP和TIMP-1致脑损伤中的作用[J]. 中山大学学报(医学科学版), 2013, 34(2):230-234.
[18] 刘凯歌. 脑出血患者术后血清MMP-9、TGF-β1水平与颅内感染的相关性[J]. 中国实用医刊, 2020, 47(24):63-66.
[19] Yu-Juan H E, Pediatrics D O. Analysis of changes in serum levels of inflammatory factors, MMPS and TIMP in newborns with intracranial hemorrhage[J]. Journal of Qiqihar Medical University, 2018, 33(88):e322.
[20] 罗芳, 林慧佳, 王陈红, 等. 振幅整合脑电图对新生儿重症监护病房神经系统高风险危重患儿的脑功能监测意义[J]. 中华儿科杂志, 2013, 51(8):614-620.
[21] Schreiner C, Hammerl M, Neubauer V, et al. Amplitude-integrated electroencephalography signals in preterm infants with cerebral hemorrhage[J]. Early Human Development, 2021, 154(8):105309.