新生儿缺氧缺血性脑损伤的三种影像学诊断特性比较

目的：比较头颅超声（US）、CT及磁共振成像（MRI）三种影像学方法对新生儿缺氧缺血性脑损伤（HIBD）的诊断特性，方法：对20例新生儿HIBD和15例正常新生儿进行US、CT及MRI同步对照检查。结果：头颅US、CT、MRI以诊断新生儿HIBD的正确诊断率及阳性率分别为89％和80％、94％和90％、91％和85％，三者的阴性率均为100％。US对早期脑室周围白质软化的分辨率明显高于CT和MRI。MRI能清晰地诊断以往US和CT未能诊断的旁矢状区损伤，借助MRI诊断，旁矢状区损伤在CT中的表现也得以辨认，三种影像诊断方法对脑水肿、基底神经节丘脑损伤、脑动脉梗死及晚期脑室周围白质软化的分辨率基本相似，结论：US、CT和MRI对诊断不同的新生儿颅内病变各具特点，临床应合理选择，互补诊断，以进一步提高新生儿颅内病变的正确诊断率。

Diagnosing features of three types cranial imaging in hypoxic-ischemic brain damage of neonates

Objective To explore and compare the diagnostic features of cranial ultrasound (US), CT and MRI in hypoxic-ischemic brain damage of neonates. Methods US, CT and MRI examinations were synchronously undertaken in 20 neonates with hypoxic-ischemic brain damage and 15 normal neonates, respectively. Results The correct diagnostic rates and the positive rates of diagnosing HIE were 89% and 80% by US, 94% and 90% by CT, 91% and 85% by MRI, respectively. US was more sensitive than the other two imaging techniques to identify the early periventricular leukomalacia (PVL). MRI could identify the parasagittal brain injuries, which was never diagnosed by US and CT. Based on the MRI findings, the parasagittal brain injuries might be recognized by CT. The resolution was similar basically by using US, CT and MRI in the diagnosis of the brain swelling, status marmoratus of basal ganglia and thalamus, as well as the cerebral arterial infarction. Conclusion US, CT and MRI showed different features in the diagnosis of various hypoxic-ischemic brain damages. It is suggested in the clinical practice to select eligibly and to apply mutually in order to improve the correct diagnostic rate of the intracranial damage in neonates.