新生儿缺氧缺血性脑病早期脑损伤的彩超声像图表现

目的　探讨彩超在新生儿缺氧缺血性脑病 (HIE)诊断中的应用价值。方法　应用彩超监测了 4 3例 HIE患儿及 14例正常新生儿脑血流参数、大脑内侧面上部边缘血管网 (VRUMS)、脑实质回声的变化 ,并于 7d内行 CT扫描。结果　HIE时大脑动脉、大脑大静脉 (GCV)的血流参数变化规律与 VRUMS的变化规律相一致 ,第一个 2 4 h的检测及连续动态观测最有意义。GCV流速 <6 cm/ s、内径 <3mm或流速 >9cm/ s、内径 >4 .5 mm是血管调节功能失调的标志之一。用彩色多普勒能量图 (CDE)监测 VRUMS,对判断 HIE患儿的灌注损伤有直接定性的作用。 HIE患儿二维声像图有特征性表现。结论　彩超在 HIE中的应用有重要价值。

Color Ultrasonographic Evaluation of Early Imaging Manifestation of Hypoxic-ischaemic Encephalopathy in Neonatal Cerebral Damage

Objective To study the application value of color ultrasound in hypoxic-ischaemic encephalopathy (HIE).Methods The changes of cerebral blood flow parameters and the vascular rete of upper border of medial surface of the cerebral hemisphere (VRUMS) were observed on ultrasonograms of the cerebral tissues in 43 neonates with HIE and 14 healthy neonates from the first to fourth day after birth.All cases underwent cranial CT within 7 days after birth.Results The neonates with HIE had parallel changes with cerebral arteries great cerebral vein (GCV) and VRUMS.The observation at the first day after birth and at the continuous monitoring were the most important.The velocities of GCV were increased to 9.0 cm/s or decreased below 6.0 cm/s and the diameter of GCV increased to 4.5 mm or decreased below 3 mm could be used as a mark to demonstrate failure of the regulatory function of cerebral blood vessels.The monitoring VRUMS of HIE by color Doppler energy was important in judging the perfusion injury.Conclusions Cranial B-mode ultrasound has characteristic manifestations in HIE.Color ultrasound has great value in HIE diagnosis.