颅脑超声在诊断早产儿脑白质软化中的诊断效能研究  

Study on the diagnostic efficacy of craniocerebral ultrasonography for periventricular leukomalacia in premature infants

作　　者：查琳[1] 张丙宏[1] 

机构地区：[1]武汉大学人民医院儿科,湖北武汉430060

出　　处：《中国妇幼保健》2015年第20期3512-3514,共3页Maternal and Child Health Care of China

摘　　要：目的 探讨颅脑超声在早产儿脑白质软化（PVL）中的应用价值。方法 选取2012年8月-2014年8月收治的57例疑似PVL早产儿（包括在华中科技大学附属同济医院新生儿科进修期间的患儿）,以弥散加权核磁成像（DWI）为参照,根据DWI检查结果分为PVL组（15例）和无PVL组（42例）,所有患者同时行颅脑超声检查,分析颅脑超声表现及诊断效能。结果 15例PVL患儿中,10例患儿发现多个大小不等的无回声或低回声囊腔,3例患儿未发现囊腔,2例患儿失访;10例发现囊腔患儿中,〈1个月消失1例,1个月-消失2例,≥2个月消失3例,2例患儿在3个月后随访时发现双侧脑室存在轻度增大,并且侧壁不规则表现,2例患儿失访;15例PVL患儿中,颅脑超声检出12例,误诊3例;42例非PVL患儿中,颅脑超声检出39例,误诊3例,颅脑超声诊断灵敏度、特异性、准确度、阳性预测值、阴性预测值分别为80.00%、92.86%、89.47%、80.00%、92.86%。结论 颅脑超声作为一种有效的工具,具有较高的诊断效能,可作为PVL早产儿诊断的首选诊断方法。Objective：To explore the application value of craniocerebral ultrasonography in diagnosis of periventricular leukomalacia（PVL） in premature infants.Methods：Fifty-seven premature infants（including the premature infants from Tongji Hospital Affiliated to Huazhong University of Science and Technology） suspected of PVL were selected from August 2012 to August 2014,then the premature infants were divided into PVL group（15 cases） and non-PVL group（42 cases）; craniocerebral ultrasonography was performed among the cases to analyze ultrasonic finding and diagnostic efficacy.Results：Among 15 PVL premature infants,multiple lumens without echo or with low echo were found in 10 premature infants,no lumen was found in 3 premature infants,and 2 premature infants were lost to follow up.Among 10 premature infants with lumens,lumens disappeared within one month in one premature infant,lumens disappeared from one month to shorter than two months in two premature infants,lumens disappeared within no less than two months in three premature infants.Mild ventricle dilation was found during follow-up in two premature infants after three months,and the side wall was irregular,two premature infants were lost to follow up; among 15 premature infants with PVL,12 premature infants were detected by craniocerebral ultrasonography,and the other three premature infants were misdiagnosed; among 42 premature infants without PVL,39 premature infants were detected by craniocerebral ultrasonography,and the other three premature infants were misdiagnosed.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value were 80.00%,92.86%,89.47%,80.00%,and 92.86%,respectively.Conclusion：The diagnostic efficacy of craniocerebral ultrasonography is relatively high as an effective tool,craniocerebral ultrasonography can be used as the preferred diagnostic method for diagnosis of PVL in premature infants.

关 键 词：脑白质软化 早产儿 颅脑超声 弥散加权核磁成像 诊断效能 

分 类 号：R445.1[医药卫生—影像医学与核医学]