新生婴儿脑动脉梗塞的B超、CT和MRI表现  

Manifestations of cerebral infarction on ultrasound,CT and MRI in neonates

作　　者：陈惠金[1] 谢利娟[1] 陈冠仪[1] 李玉华[1] 朱杰明[1] 

机构地区：[1]上海第二医科大学附属新华医院上海市儿科医学研究所,200092

出　　处：《中国实用儿科杂志》2005年第2期75-77,i001-i002,共5页Chinese Journal of Practical Pediatrics

摘　　要：目的探讨新生儿及小婴儿脑动脉梗塞的B超、CT和MRI影像诊断特点.方法 1998年12月至2000年2月期间,对入住上海新华医院新生儿病区的新生儿及小婴儿同时进行头颅B超、CT和MRI检查,并酌情复查.结果 5例足月小婴儿被诊断为脑动脉梗塞,其中重度窒息2例,轻度窒息1例,均在新生儿期后0.5～3个月因惊厥收住院.脑动脉梗塞部位涉及大脑前、中、后动脉所分布区域,以左侧中动脉梗塞较为常见.B超可清晰诊断脑动脉梗塞的早期(强回声)和晚期(低回声),但未能诊断大脑后动脉梗塞;CT和MRI对整体颅脑病变的显示优于B超,但对脑动脉梗塞的早、晚期则均呈现相同的低密度或T1低信号.结论 B超、CT和MRI均可诊断脑动脉梗塞,其中B超可床边检查,对颅脑中央部位的病变分辨力高,应为新生儿颅内病变的首选影像诊断方法.Objective To explore the features of ultrasound,CT and MRI for the diagnosis of cerebral infarction in neonates and young infants.Methods Ultrasound,CT and MRI examinations were performed simultaneously on all neonates and young infants who were admitted into neonatal wards of Xinhua Hospital from Dec.1998 to Feb.2000.Results Five full-term young infants were diagnosed as cerebral infarction.Among them,there were two cases of severe asphyxia and one mild asphyxia when they were born.All of five infants developed seizures at 0.5~3 months after neonatal period.The locus of cerebral infarction involved in areas distributed by cerebral anterior,middle or posterior arteries,but the infarction of left middle artery was more common.The early stage (intense echodense) and late stage (weak or no echodense) of cerebral infarction were well distinguished by ultrasound.However,ultrasound had not recognized the infarction of cerebral posterior artery in two cases.It seemed to be clearer on CT and MRI for the manifestation of integral intracranial changes comparing with that on ultrasound,although CT and MRI were not able to distinguish early or late stages of cerebral infarction.Conclusion Cerebral infarction can be diagnosed by either ultrasound,CT or MRI. It is feasible that ultrasound should be advocated as a preferred imaging manner for the diagnosis of intracranial changes in neonates and young infants owing to its bedside examination conveniently and higher resolving power for the central changes of intracranium.

关 键 词：脑动脉梗塞超声 CT MRI 新生儿 婴儿 

分 类 号：R72[医药卫生—儿科]