| 徐文彪,刘立炜,周少毅,李建明,李燕萍.新生儿缺氧缺血性脑病CT诊断及随访观察[J].中国医学影像技术,2003,19(3):321~323 |
| 新生儿缺氧缺血性脑病CT诊断及随访观察 |
| CT Diagnosis and Follow-up Study of Hypoxic-Ischemic Encephalopathy |
| 投稿时间：2002-08-09 |
| DOI： |
| 中文关键词: 新生儿 缺氧缺血性脑病 CT 随访观察 |
| 英文关键词:Newborn Hypoxic ischemic encephalopathy CT Follow-up |
| 基金项目:本课题是广东省卫生厅立项科研课题(B1999152)。 |
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| 中文摘要: |
| 目的 通过对120例足月新生儿缺氧缺血性脑病(HIE)进行CT诊断及随访复查,了解HIE的CT表现及其所产生的各种后遗症的发生规律。方法 对120例HIE患儿进行CT检查,初次CT扫描时间为生后4~10天,追踪复查时间分别为生后1个月,3个月,半年,1年,1年半,2年及2年以上。结果 ①本组120例HIE中,轻度39例,中度67例,重度14例。②HIE病灶分布在左额叶119例,右额叶119例,左颞叶48例,右颞叶52例,左顶叶75例,右顶叶75例,枕叶18例。③合并颅内出血情况:本组SAH 67例,IVH 5例,SDH 2例,IPH 3例,SHE 2例。④随访复查:最后一次CT复查所见,正常46例,外部性脑积水28例,单纯脑沟加深26例,脑软化13例,脑萎缩7例,脑梗塞7例,脑穿通畸形3例,脑钙化灶5例,死亡2例。结论 ①HIE病灶首先累及双侧额叶,其次为顶叶、颞叶、枕叶。②HIE以合并SAH最常见,中、重度HIE合并颅内出血发生率较高,轻度较少。③外部性脑积水和脑沟加深是HIE最常见的异常改变,其中大多数病例可完全或基本恢复。而脑软化、脑萎缩、脑梗塞、脑穿通畸形、脑钙化灶为不可逆性后遗症。 |
| 英文摘要: |
| Objective To find out the CT features, all kinds of sequela and their regularities of hypoxic-ischemic encephalopathy(HIE). Methods CT scans were performed on 120 full-term newborn infants with HIE. The initial CT examination was at the age of 4-10 days, with follow-up examinations at the 1st, 3rd, 6th, 12th, 18th, 24th months and at over the age of two years. Results ①39 minor cases, 67 moderate cases and 14 severe cases were found in 120 patients. ②Bilateral frontal and parietal lobes, left temporal lobes, right temporal lobes and occipital lobes were involved in 119,75,48,52 and 18 patients accordingly. ③Occurances of intracranial bleeding: SAH, IVH, SDH, IPH and SHE were in 67,5,2,3 and 2 patients accordingly. ④Follow-up study: findings on the last CT scanning, 46 cases were normal, 28 cases were external hydracephalus, 26 cases only with deepened sulcus, 13 cases were encephalmalacia, 7 cases were cerebral atrophy, 7 cases were cerebral infarction, 3 cases were porencephaly, 5 cases only had cacified lesions and 2 cases died. Conclusion ①HIE was prior to involving bilateral frontal lobes, and then parietal, temporal and occipital lobes. ②The most common complication of HIE was SAH, intracranial bleeding was commonly presented in moderate HIE and severe HIE, and then in mild HIE. ③EH and deepened sulcus were the most common abnormal findings in HIE, most of them could fully recover or partially recover from HIE. As the sequelae of HIE, encephalomalacia, cerebral atroyhy, cerebral infarction, porencephacy and calcifield lesions might never recover from HIE. |
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