新生儿缺氧缺血性脑病CT随访再认识

进一步探讨新生儿缺氧缺血性脑病的发展转归，ＣＴ分离与预后的关系，并评价ＣＴ在ＨＩＥ随访中的应用价值。方法选择围产期窒息史，头颅ＣＴ诊断为不同程度的ＨＩＥ新生儿６２例。根据脑水肿范围、程度，将ＨＩＥ分为轻、中、重３度、，分别对于３个月、６个月、１岁、２岁和４岁内进行头颅ＣＴ复查。结果ＨＥ所致脑低密度灶在生后３个月内吸收消失；３－６个月时可引起外部性脑积水，１岁以后，ＥＨ的表现消失；３个月以及后可引起

Further recognition of CT follow-up of neonatal hypoxic ischemic encephalopathy

Objective:To study the course and sequelae of neonatal hypoxic ischemic encephalopathy (HIE),the relation between the CT grading and the prognosis,and to assess the value of CT in follow-up of HIE.Methods:Sixty-two cases of asphyxial perinatal neonates were selected,and CT gradiag was made.HIE was graded into mild,moderate and severe degrees according to the extent and degree of cerebral edema.Follow-up was carried out at the 3rd,6th month,one and two years of age and before four years old.Results:Cerebral low density lesion was absorbed in 3 months;HIE might cause external hydrocephalus (EH) at 3rd-6th month,and EH disappeared one year later;HIE might cause periventricular leukomalacia (PVL) after the 3rd month.The incidence of PVL was 11.6%, 64.3% and 80%,respectively with mild,moderate and severe degree HIE,and that of severe degree PVL was 20%,33.3% and 75%. Severe degree HIE might cause cerebral malacia and atrophy (80%) in 2 months.Conclusions:Prognosis of HIE was closely related to the degree of abnormal manifestations on CT:Mild degree HIE might have good prognosis,moderate to severe degree HIE might have bad porgnosis. PVL,cerebral malacia and atrophy became late serious complications of HIE.