缺血缺氧性脑病新生儿头颅CT表现  

Cranial CT findings of neonatal hypoxic ischemic encephalopathy

作　　者：鲁涛[1] 李铭[2] LU Tao;LI Ming(Department of Radiology,Anyang Maternal and Child Health Care Hospital,Anyang 455000,P.R.China;Department of Imaging,Anyang Tumour Hospital,Anyang 455000,P.R.China)

机构地区：[1]安阳市妇幼保健院放射科,河南安阳455000 [2]安阳市肿瘤医院影像科,河南安阳455000

出　　处：《社区医学杂志》2019年第14期866-868,872,共4页Journal Of Community Medicine

基　　金：河南省科技攻关计划（52102310032）

摘　　要：目的新生儿缺血缺氧性脑病(hypoxic ischemic encephalopathy,HIE)发病率、致残率高,是新生儿常见急危症。本研究探讨HIE患儿头颅CT表现及应用价值。方法选取安阳市妇幼保健院和安阳肿瘤医院2016-05-01-2017-05-01接收的36例HIE患儿为观察组,另外,选择同期出生的有临床症状,但CT检查无异常者36例作为对照组,均行头颅CT扫描,采用BrillianceTM(64Slice)CT扫描机对其丘脑、基底节、灰质和白质部位进行测量,选低密度区测2~3次,取其平均值。观察不同分级程度HIE患儿CT表现,并比较其CT检测值。结果观察组36例HIE患儿中,轻度10例,中度14例,其中1例合并室管膜下出血,13例合并蛛网膜下腔出血,重度12例,12例均合并有蛛网膜下腔出血;中度组脑白质、基底节和脑灰质CT分别为(20.3±3.3)、(20.5±3.1)和(25.7±3.5),重度组分别为(11.3±2.1)(16.9±2.7)和(22.1±2.3),较对照组低,差异有统计学意义,均P<0.05;重度组脑CT值低于中度组和轻度组,差异有统计学意义,均P<0.05。结论头颅CT检查能反映新生儿缺血缺氧性脑病病变范围、部位及程度,对早期诊断和治疗具有指导意义。OBJECTIVE The incidence and disability rate of hypoxic ischemic encephalopathy(HIE)are high.It is a common emergency disease in newborns.This article discusses the CT manifestations of HIE and its application value.METHODS A total of 36 children with HIE admitted to Anyang Maternal and Child Health Care Hospital and Anyang Tumour Hospital were as observation group from May 1,2016 to May 1,2017.In addition,36 children with anoxia without perinatal asphyxia at the same time were selected as control.The CT scan of the head was performed with BrillianceTM(64 Slice)CT scanner(produced by Philips company).The thalamus,basal ganglia,gray matter and white matter were measured,and the average value was measured 2-3 times in the low density area.RESULTS Among 36 children with HIE,there were 10 mild cases,14 moderate cases and 12 severe cases.Among 14 moderate cases,1 cases had subependymal hemorrhage and 13 cases had subarachnoid hemorrhage.All 12 severe cases were with subarachnoid hemorrhage.Compared with the control group,the CT values of white matter(20.3±3.3),basal ganglia(20.5±3.1),and cerebral gray matter(25.7±3.5)were significantly lower in the moderate group.The differences were significant(all P<0.05).The CT valcces of the above parts in the severe group were(11.3±2.1),(16.9±2.7)and(22.1±2.3).In addition,the CT value of severe group was significantly lower than that of moderate group and mild group,and the differences were significant.CONCLUSION The cranial CT examination can reflect the range,location and degree of neonatal hypoxic-ischemic encephalopathy,which is of guiding significance for early diagnosis and treatment.

关 键 词：头颅CT表现 脑灰质 缺血缺氧性脑病 基底节 脑白质 

分 类 号：R722.1[医药卫生—儿科]