彩色多普勒超声鉴别诊断婴儿硬膜下积液与良性蛛网膜下腔增宽

目的探讨婴儿硬膜下积液或积脓与良性蛛网膜下腔增宽的声像图差异。方法分析14例硬膜下积液／积脓和13例良性蛛网膜下腔增宽的声像图特点，观察二者积液区部位、形态、边缘、回声强度、并发症及彩色血流信号。结果硬膜下积液14例中，7例积液为双侧，其中1例两侧积液区外形对称；13例病变区内缘平直、光滑；2例硬膜下积脓患儿液性暗区内可见条状强回声；所有病例均未见“皮层静脉征”。良性蛛网膜下腔增宽13例中，积液均发生于双侧，且双侧对称；所有病例均可见积液区内缘呈脑回样起伏，扩张间隙内可见彩色血流信号穿过，即“皮层静脉征”阳性。结论彩色多普勒超声是鉴别婴儿硬膜下积液／积脓与良陛蛛网膜下腔增宽的重要无创手段。

Differential diagnosis of subdual collection of fluid and benign subarachnoid spaces dilatation in infants by color Doppler ultrasound

Objective To explore the difference of sonograms for subdual collection of fluid and benign subarachnoid spaces dilatation in infants by color Doppler ultrasound. Methods Fourteen cases of subdural collection of fluid and 13 cases of benign subarachnoid spaces dilatation were enrolled in this study. Then their sonogram features were analyzed, and their location, shape, edge, echo intensity, complications and color blood signals of fluidify were observed. Results In subdural collection of fluid group (14 cases), 7 cases (50%) were bilateral fluidify, only 1 case (7.1%) was symmetrical. The inner edge of diseased region showed straight and smooth in 13 cases (92.9%), 2 cases with subdural empyema were found strip strong echo in fluidify area opaca. "Cortical vein sign"was not found in all the cases. In benign subarachnoid spaces dilatation group (13 cases), the fluidify of all cases was distributed bilaterally and symmetrically, and all the cases (100%) showed irregular, gyre-like in inner margin, "Cortical vein sign" was found in all the cases. Conclusion Color Doppler ultrasound is an important and noninvasive method in differential diagnosis of subdural collection of fluid and benign subarachnoid spaces dilatation in infants.