426例新生儿颅脑超声检查结果分析

目的 探讨颅脑超声评价新生儿脑部疾病的价值。方法 回顾性分析接受颅脑检查的426例新生儿的超声图像，其中正常出生体质量儿144例，低出生体质量儿272例，巨大儿10例；根据是否足月，将患儿分为早产儿组（n=255）和足月儿组（n=171）。比较2组及不同体质量新生儿颅脑疾病检出率的差异。结果 426例中，386例头颅超声检查结果正常；40例异常，包括7例脑室内出血（IVH），31例室管膜下囊肿（SEC），2例脑积水。早产儿组中，6例（6/255，2.35%）IVH，16例（16/255，6.27%）SEC；足月儿组中，1例（1/171，0.58%）IVH，15例（15/171，8.77%）SEC，2例（2/171，1.17%）脑积水；2组IVH、SEC及脑积水检出率比较差异均无统计学意义（P均>0.05）。272例低出生体质量患儿中，6例（6/272，2.21%）IVH，15例（15/272，5.51%）SEC；144例正常出生体质量患儿中，1例（1/144，0.69%）IVH，15例（15/144，10.42%）SEC，2例（2/144，1.39%）脑积水；10例巨大儿中，1例（1/10，10.00%）SEC，无IVH及脑积水。不同出生体质量患儿IVH、SEC及脑积水的检出率差异均无统计学意义（P均>0.05）。40例头颅超声检查结果异常的患儿中，13例伴中枢神经系统症状者，27例无中枢神经系统症状。结论 头颅超声有助于检出新生儿颅内病变，尤其是无症状的严重病变。

Analysis of transcranial ultrasonography in 426 neonatal brains

Objective To explore the value of craniocerebral ultrasonography in evaluation on neonatal brain diseases. Methods Ultrasonic images of 426 newborns were reviewed retrospectively. Among 426 newborns, 144 newborns were normal birth weight infants, 272 newborns were low birth weight infants and 10 newborns were macrosomia. According to whether the newborns were full-term, they were divided into premature group (n=255) and full-term group (n=171). The detection rate of craniocerebral diseases between the 2 groups and newborns of different weights were compared. Results Among the 426 newborns, normal transcranial ultrasonic findings were found in 386 newborns, intracranial lesions were found in 40 newborns, including intracranial hemorrhage (ICH) was found in 7 newborns, subependymal cyst (SEC) was found in 31 newborns and hydrocephalus was found in 2 newborns. In premature group, IVH was found in 6 (6/255, 2.35%) newborns, while SEC was found in 16 (16/255, 6.27%) newborns. In full-term group, IVH was found in 1 (1/171, 0.58%) newborn, SEC was found in 15 (15/171, 8.77%) newborns, and hydrocephalus was found in 2 (2/171, 1.17%) newborns. There was no significant difference in the detection rates of IVH, SEC and hydrocephalus between the two groups (all P>0.05). Among the 272 low birth weight newborns, IVH was found in 6 (6/272, 2.21%) newborns, while SEC was found in 15 (15/272, 5.51%) newborns. Among the 144 normal birth weight newborns, IVH was found in 1 (1/144, 0.69%) newborn, SEC was found in 15(15/144, 10.42%) newborns, and hydrocephalus was found in 2 (2/144, 1.39%) newborns. Among the 10 macrosomia, SEC was found in 1 (1/10, 10.00%) newborn, while IVH and hydrocephalus were not found. There was no significant difference in the detection rates of IVH, SEC and hydrocephalus in newborns with different birth weights (all P>0.05). Among the 40 abnormal lesions, central nervous system symptoms was found in 13 newborns, while not found in 27 newborns. Conclusion Transcranial ultrasound is helpful in detecting intracranial lesions in newborns, especially in severe situations without specific clinical manifestation.