新生儿肾上腺出血的B超、CT诊断比较

目的 分析比较B超、CT诊断新生儿肾上腺出血的价值.方法 回顾性分析8例经证实的新生儿肾上腺出血病例,对比分析腹部B超及CT表现,男5例,女3例,发病时日龄1～14d.结果 8例均为右侧肾上腺出血,B超显示右肾上腺区三角形或类圆形病灶,边界清楚锐利可探及完整包膜;强回声2例,低回声2例,强弱混杂回声4例;4例复查体积较前均明显缩小,呈无回声区.CT平扫为单发圆形或卵圆形肿块影,均匀高密度3例;均匀低密度2例;呈环状中心高密度3例.3例复查肿块密度较前减低,体积较前缩小,1例内部小点状钙化灶.结论 应使用B超对新生儿进行肾上腺出血筛查,进一步的CT扫描可提供影像学分期.随访病例应注意残留囊性病变的观察,分析有无钙化灶的形成.

Ultrasound and CT diagnosis of adrenal hemorrhage in newborn

Objective To study B-mode ultrasound and CT imaging feature differences of adrenal hemorrhage in neonate. Methods Eight newborns with adrenal hemorrhage,1～14 days after birth, 5 males and 3 females,were analyzed retrospectively. Ultrasound and CT were performed in all patients. Results All cases with right adrenal hemorrhage,triangle or oval-like mass with sharp boundary and completed envelop were revealed in B-mode ultrasound. 2 cases were high echoic,2 cases were low echoic, 4 cases were heterogeneous,the mass were obviously to contract in 4 re-exam cases. Single round or oval mass were revealed on plain CT scan,3 cases with high density,2 with low density,3 with circle high density. The mass density was decreased and volume Was diminished in 3 re-exam cases, internal punctate calcification were showed in 1 case.Conclusion B-mode ultrasound screening is recommended to perform in suspected newborn,advanced CT scan can stage adrenal hemorrhage. Cyst form and calcification were important follow-up changes.