床旁颅脑超声与CT对新生儿颅内出血的诊断价值比较  

Comparison of the diagnostic value of bedside craniocerebral ultrasound and CT for neonatal intracranial hemorrhage

作　　者：李亚珂 LI Yake(Department of Ultrasound,Pingmei Shenma Medical Group General Hospital,Pingdingshan 467000,China)

机构地区：[1]平煤神马医疗集团总医院超声科,平顶山467000

出　　处：《中国实用医刊》2024年第21期65-68,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较床旁颅脑超声与CT对新生儿颅内出血的诊断价值。方法观察性研究。抽取平煤神马医疗集团总医院2023年1月至2024年1月收治的97例疑似新生儿颅内出血患儿作为研究对象。均采用颅脑超声、CT检查;以磁共振检查结果为金标准,比较床旁颅脑超声与CT检查的诊断结果、诊断效能、颅内出血部位检出情况。结果97例疑似新生儿颅内出血患儿,采用磁共振诊断阳性59例,阴性38例;采用床旁颅脑超声诊断出阳性56例,阴性41例;采用CT诊断出阳性50例,阴性47例。床旁颅脑超声诊断特异度(94.74%,36/38)、误诊率(5.26%,2/38)和CT诊断(89.47%,34/38;10.53%,4/38)比较差异未见统计学意义(P>0.05);床旁颅脑超声诊断灵敏度(91.53%,54/59)、准确度(92.78%,90/97)高于CT诊断(77.97%,46/59;82.47%,80/97),漏诊率(8.47%,5/59)低于CT诊断(22.03%,13/59),P<0.05。床旁颅脑超声硬脑膜下出血检出比率(6/10)、脑实质出血检出比率(3/4)和CT诊断(10/10,3/4)比较差异未见统计学意义(P>0.05);床旁颅脑超声脑室周围-脑室内出血检出率(100%,45/45)高于CT诊断(73.33%,33/45),P<0.05。结论与CT诊断相比,床旁颅脑超声诊断新生儿颅内出血具有较高的灵敏度、准确度,并可降低漏诊率,但对于不同颅内出血部位二者检查各具优势,临床可结合患儿实际情况选择最佳诊断方法。ObjectiveTo compare the diagnostic value of bedside craniocerebral ultrasound and computed tomography(CT)for neonatal intracranial hemorrhage.MethodsNinety-seven infants with suspected neonatal intracranial hemorrhage admitted to Pingmei Shenma Medical Group General Hospital from January 2023 to January 2024 were selected as research objects for the observational study.And they all underwent craniocerebral ultrasound and CT examinations.and Taking the magnetic resonance imaging examination results as the gold standard,the diagnostic results,diagnostic efficacy,and detection results of intracranial hemorrhage sites were compared between bedside craniocerebral ultrasound and CT examination.ResultsAmong the 97 infants with suspected neonatal intracranial hemorrhage,magnetic resonance imaging identified 59 positive cases and 38 negative cases.Bedside craniocerebral ultrasound identified 56 positive cases and 41 negative cases.CT identified 50 positive cases and 47 negative cases.The specificity and misdiagnosis rate of bedside craniocerebral ultrasound(94.74%,36/38;5.26%,2/38)had no significant difference with CT diagnosis(89.47%,34/38;10.53%,4/38),P>0.05.The sensitivity and accuracy of bedside craniocerebral ultrasound diagnosis(91.53%,54/59;92.78%,90/97)were higher than those of CT diagnosis(77.97%,46/59;82.47%,80/97),P<0.05.The miss diagnosis rate of bedside craniocerebral ultrasound diagnosis was 8.47%(5/59),lower than the 22.03%(13/59)of CT diagnosis(P<0.05).There was no significant difference in the detection rate of subdural hematoma and cerebral parenchymal hemorrhage between bedside craniocerebral ultrasound(6/10,3/4)and CT diagnosis(10/10,3/4),P>0.05.The detection rate of periventricular-intraventricular hemorrhage of bedside craniocerebral ultrasound(100%,45/45)was higher than that of CT diagnosis(73.33%,33/45),P<0.05.ConclusionCompared with CT diagnosis,bedside craniocerebral ultrasound has higher sensitivity and accuracy in the diagnosis of neonatal intracranial hemorrhage,and can reduce missed diagnosis

关 键 词：新生儿 颅内出血 床旁颅脑超声 电子计算机断层扫描 

分 类 号：R722.1[医药卫生—儿科] R445.1[医药卫生—临床医学]