超声与CT诊断新生儿颅内出血的临床价值

目的:评价超声与CT诊断新生儿颅内出血的临床价值,探讨诊断新生儿颅内出血准确简便的方法。方法:对141例同时接受超声与CT检查,且诊断为颅内出血的新生儿的超声与CT诊断结果进行分析比较。结果:141例颅内出血(NIH)新生儿中,由超声诊断新生儿颅内出血共120例,诊断符合率为85.11%(120/141),超声漏诊新生儿颅内出血21例,其中单纯蛛网膜下腔出血(SAH)16例,脑实质出血(IPH)合并蛛网膜下腔出血(SAH)2例,硬脑膜下出血(SDH)合并蛛网膜下腔出血(SAH)3例。IPH合并SAH漏诊的2例,均为诊断出IPH但漏诊SAH,SDH合并SAH漏诊的3例,均为诊断出SDH但漏诊SAH。漏诊率为14.89%(21/141);由CT诊断新生儿颅内出血共130例,诊断符合率为92.20%(130/141),CT漏诊新生儿颅内出血11例,其中脑室管膜下出血(SHE)5例,脑室内出血(IVH)6例,漏诊率为7.80%(11/141)。结论:超声与CT检查是诊断新生儿颅内出血(NIH)较好的辅助手段,两者对于诊断新生儿颅内出血各具特点,互有利弊。建议对高危新生儿,特别是早产儿应首先进行常规超声检查,如超声检查是阴性,而临床又高度怀疑颅内出血者,则进一步行CT检查。

An evaluation in diagnosis intracranial hemorrhage of newborn by B ultrasonic and CT

Objective:To investigate the value of B ultrasonic and CT in the diagnosis intracranial hemorrhage of newborn.Methods:141 newborns with intracranial hemorrhage were examined by B ultrasonic and CT at the same time to analyze the outcomes of B ultrasonic and CT.Results:120 cases were diagnosed as intracranial hemorrhage by B ultrasonic,the coincidence was 85.11%(120/141),missed diagnosis 21 cases(14.89%),including subarachnoid hemorrhage(SAH) 16 cases,IPH(intraparenchyma hemorrhage) with SAH 2 cases,SDH(subdural hemorrhage) with SAH 3 csases.and 130 cases diagnosed as intracranial hemorrhage by CT,the coincidence was 92.20%(130/141),missed diagnosis 11 cases(7.80%),including subependyma hemorrhage 5 cases,encephalocoele hemorrhage 6 cases.Conclusion:B ultrasonic and CT are preferable methods to diagnose intracranial hemorrhage of newborns with advantages and disadvantages.The newborns with high risk,especially preterm infants,should undergo B ultrasonic routinely.If the outcome of B ultrasonic is negative,CT should be undergone when intracranial hemorrhage can't be excluded.