Early Diagnostic Value Of Different Examination Methods For Neonatal Brain Injury Caused By Intrauterine Infection

Objective To explore the correlation between amplitude integrated electroencephalogram(a EEG),brain magnetic resonance imaging(MRI)and serum S100 B protein and neonatal brain injury,and to analyze the value of different examination methods in early diagnosis of neonatal brain injury caused by intrauterine infection.Methods Ninety-nine neonates with intrauterine infection who were born in Qingdao municipal hospital from may 2018 to may 2019 or transferred from the outer hospital within 24 hours after birth were selected as the research subjects.all the research subjects underwent a EEG examination within 72 hours after birth,and thecontinuity,periodicity,lower boundary amplitude and popper band width inhibition of a EEG background activity were normalized and interpreted,and a EEG comprehensive score was made on them.All the subjects completed MRI examination within 14 days after admission to the hospital,and interpreted the damages in various brain regions to determine the extent of the damages.Serum S100 B protein levels were measured on the 1st,3rd and 7th days after birth.The a EEG,MRI and serum S100 B protein indexes between brain injury group and non-brain injury group were compared and analyzed.Among all the selected subjects,full-term infants were all 7 days old and premature infants were all given 20 items of neurobehavioral tests(NBNA)scores at the corrected gestational age of 40 weeks.According to the NBNA score results,all the subjects were divided into: ?35 points,brain injury group,61 cases;> 35 points,non-brain injury group,38 cases;The correlation between a EEG score,MRI results,S100 B protein level,a EEG+MRI,a EEG+S100B,MRI+S100B and NBNA score was analyzed.Result AEEG: The continuity,periodicity,popple zone width inhibition degree,lower boundary amplitude and a EEG comprehensive score abnormality degree of the brain injury group are higher than those of the non-brain injury group.The difference of a EEG background activity between the brain injury group and the non-brain injury group is statistically significant(P < 0.05).MRI: The abnormal degree of MRI in each region of brain injury group was higher than that of non-brain injury group,and the difference of MRI results between brain injury group and non-brain injury group was statistically significant(P < 0.05).Serum S100 B protein: the serum S100 B level of brain injury group was significantly higher than that of non-brain injury group at various time points after the birth of the newborn.the difference in serum S100 B between brain injury group and non-brain injury group was statistically significant(p <0.05).ROC curve: The AUC value obtained by plotting ROC curve with a EEG score is0.806(95% confidence interval: 0.720-0.891),the sensitivity is 0.639,and the specificity is 0.921;The AUC value obtained by plotting ROC curve of MRI results is 0.731(95%confidence interval: 0.624-0.837),the sensitivity is 0.803,and the specificity is 0.658;The AUC value obtained by drawing ROC curve for serum S100 B protein level is0.791(95% confidence interval: 0.696-0.886),sensitivity is 0.738,and specificity is0.789.S100B+MRI Results The AUC value obtained by plotting ROC curve was0.808(95% confidence interval: 0.719-0.897),the sensitivity was 0.721,and the specificity was 0.895.S100B+a EEG Results The AUC value obtained by plotting ROC curve was 0.790(95% confidence interval: 0.738-0.842),the sensitivity was 0.738,and the specificity was 0.842.AUC value of a EEG+MRI results plotted by ROC curve is0.841(95% confidence interval: 0.758-0.924),sensitivity is 0.787,specificity is 0.895;The specificity of single a EEG examination is higher,but the area under ROC curve corresponding to a EEG+MRI is the largest,suggesting higher diagnostic accuracy.Conclusion The indexes of aEEG,MRI and S100 B protein are closely related to the early brain injury of newborn and have clinical value in early prediction of neonatal brain injury.However,the combination of a EEG+MRI,a EEG+S100B and MRI+S100B in the diagnosis of neonatal brain injury is more accurate than the single examination method.It can comprehensively identify early brain injury and is more sensitive to brain injury.Among them,a EEG+MRI combined detection has the highest sensitivity and specificity for early diagnosis of neonatal brain injury.