彩色多普勒血流成像对新生儿颅脑损伤诊断的价值研究  

Study on the diagnostic value of color Doppler flow imaging for neonatal traumatic brain injury

作　　者：王佳佳[1] 许永强[1] 郝娟[2] 彭彬[2] WANG Jia-jia;XU Yong-qiang;HAO Juan(Department of Ultrasound,Bengbu First People's Hospital,Bengbu Anhui 233000,China;Department of Neonatology,Bengbu First People's Hospital,Bengbu Anhui 233000,China)

机构地区：[1]蚌埠市第一人民医院超声科,安徽蚌埠233000 [2]蚌埠市第一人民医院新生儿科,安徽蚌埠233000

出　　处：《临床和实验医学杂志》2024年第15期1667-1670,共4页Journal of Clinical and Experimental Medicine

基　　金：安徽省医学会临床研究项目(编号:2021001375)。

摘　　要：目的探究彩色多普勒血流成像(CDFI)对新生儿颅脑损伤的诊断价值。方法选取2021年1月至2023年12月期间蚌埠市第一人民医院疑似颅脑损伤新生儿临床资料进行回顾性分析,共计63例,将60例确诊为颅脑损伤的新生儿分为轻度脑损伤40例、中度脑损伤10例和重度脑损伤组10例,另选取同期本院收治的无颅脑损伤的正常新生儿20名作为对照组。对新生儿进行颅内MRI检查(临床诊断)及超声检查,比较两种诊断的准确率及对不同脑损伤类型的诊断情况;记录大脑中动脉中央支的阻力指数(RI)、收缩期峰值流速(PSV)、搏动指数(PI)。结果63例颅脑损伤新生儿中,经颅脑超声诊断颅脑损伤阳性58例,阴性5例。临床诊断或MRI诊断和颅脑超声检查新生儿颅脑损伤准确率比较差异无统计学意义(P>0.05)。以临床诊断或头颅MRI诊断标准发现缺血缺氧性脑病、脑室出血和脑水肿为新生儿颅脑损伤的主要类型。各损伤类型颅脑临床诊断或MRI和超声检查检出率比较,差异均无统计学意义(P>0.05)。轻度颅脑损伤组新生儿RI和PI分别为0.72±0.07、5.89±0.08,中度颅脑损伤组新生儿RI和PI分别为0.80±0.07、5.40±0.07,重度脑损伤组新生儿RI和PI分别为0.85±0.08、5.04±0.06,均明显高于对照组(0.61±0.05、6.18±0.10),轻度颅脑损伤组、中度颅脑损伤组、重度脑损伤组新生儿PSV分别为(37.28±3.71)、(34.36±3.52)、(30.12±3.08)cm/s,均明显低于对照组[((40.10±4.06)cm/s)],差异均有统计学意义(P<0.05);重度脑损伤组新生儿RI和PI均高于轻度脑损伤组和中度脑损伤组,PSV均低于轻度脑损伤组和中度脑损伤组,差异均有统计学意义(P<0.05)。结论颅脑超声较临床诊断或MRI诊断阳性检测可通过明确颅脑损伤新生儿血流动力学变化确定脑损伤的严重程度,因此对新生儿颅脑损伤检测更提倡应用颅脑超声检查。Objective To explore the diagnostic value of color Doppler flow imaging(CDFI)for neonatal traumatic brain injury.Methods The clinical data of newborns with suspected craniocerebral injury in Bengbu First People's Hospital were selected for retrospective analysis during the period of January 2021 to December 2023,totaling 63 cases;60 newborns diagnosed with craniocerebral injury were classified into 40 cases of mild cerebral injury,10 cases of moderate cerebral injury,10 cases of severe cerebral injury group,and the newborns in the healthy control group were the normal newborns who had no craniocerebral injury in our hospital during the same period,totaling 20 cases.Intracranial MRI(clinical diagnosis)and ultrasonography were performed on the newborns to compare the accuracy of the two diagnostic methods and the diagnosis of different types of brain injury;the resistance index(RI),peak systolic flow velocity(PSV),and pulsatility index(PI)of the central branch of the middle cerebral artery were recorded.Results Among the 63 neonates with craniocerebral injury,58 cases were positive,5 cases were negative.There was no significant difference in the accuracy of clinical diagnosis or MRI diagnosis and craniocerebral ultrasound in neonatal craniocerebral injury(P>0.05).Hypoxic-ischemic encephalopathy,intraventricular hemorrhage and brain edema were the main types of neonatal craniocerebral injury according to clinical diagnosis or cranial MRI diagnostic criteria.There was no significant difference in the detection rate of clinical diagnosis or MRI and ultrasonography among different types of injury(P>0.05).The RI and PI of neonates in the mild brain injury group were 0.72±0.07 and 5.89±0.08,respectively.The RI and PI of neonates in the moderate brain injury group were 0.80±0.07 and 5.40±0.07,respectively.The RI and PI of neonates in the severe brain injury group were 0.85±0.08 and 5.04±0.06,respectively,which were significantly higher than those in the control group(0.61±0.05 and 6.18±0.10),the PSV of neonates in

关 键 词：颅脑超声 新生儿 颅脑损伤 血流特征 临床诊断 磁共振成像 

分 类 号：R445.1[医药卫生—影像医学与核医学] R722.1[医药卫生—诊断学]