新生儿缺氧缺血性脑病的影像诊断价值  

Imaging diagnosis of neonatal hypoxic-ischemic encephalopathy

作　　者：易大勇 

机构地区：[1]湖南省岳阳市二人民医院,湖南岳阳414000

出　　处：《中国医学工程》2007年第11期916-918,共3页China Medical Engineering

摘　　要：目的探讨新生儿缺氧缺血性脑病的CT和MRI表现及诊断价值。方法回顾性分析38例有围产期窒息史患儿的CT和MRI表现及其复查CT和MRI的表现。结果38例中,初诊头部CT和MRI均有不同程度缺氧缺血性脑病征像。CT表现为脑实质内范围大小不一的低密度灶,灰、白质分界模糊,甚至消失。表现为:灰、白质信号差别消失或一个或多个脑叶白质区呈片状T1低信号及T2高信号灶,或伴有基底节区可见点状异常T2低信号灶。追踪复查CT和MRI,20例CT和MRI表现正常,4例放弃治疗死亡,余14例中,CT表现为低密度灶无明显改善,甚至遗留脑软化灶。MRI表现为脑萎缩伴随基底节区异常T2信号或脑水肿征像。结论CT和MRI相结合,对缺氧缺血性脑病有客观反映,能弥补超声诊断空白,对缺氧缺血性脑病早诊断和预后评估、脑损伤监测有一定实用价值。[Objective] To study the CT and MRI features of hypoxic-ischemic encephalopathy （HIE） in neonates and its diagnostic value. [Methods] 38 neonates with perinatal asphyxia were retrospectively studied and the fol- low-up and initial CT and MR/changes were analyzed. [Results] The initial cranial CT ＆ MR scans showed different degree signs of HIE in all cases, low-density patch with different size and blurry margin between white and gray matter in CT scan. The MR scan showed the disappearance of signal difference between white and gray matter, single or multiple patched lesions with T1 low and T2 high signal in cerebral white matter, or with spotted abnormal T2 low signal in basal ganglia areas. Follow-up observation with CT ＆ MRI revealed recovery to normal in 20 cases. The remaining 14 cases had less ameliorative low-density lesion and even encephalomalacia in CT scan, and cerebral atrophy, abnormal T2 signal in basal ganglia areas or cerebral edema in MR/scan. [Conclusions] The combination of CT and MRI is a sensitive and practical method for early diagnosis, evaluating prognosis in neonates with HIE.

关 键 词：新生儿 脑缺氧症 CT成像 磁共振成像 

分 类 号：R722.1[医药卫生—儿科] R445[医药卫生—临床医学]