【论著】新生儿缺氧缺血性脑病多层螺旋CT诊断及动态观察

  08-12-31  

李清锋黄月艳黄德尤
摘要目的探讨不同病程新生儿缺氧缺血性脑病（Hypoxic?ischemic encephalopatly, HIE）的CT分度与临床分度的关系、HIE合适的CT检查时间、HIE 的转归，以评价螺旋CT在HIE诊断、随访中的应用价值。方法选择符合最新诊断标准的HIE患儿97例，回顾1 h~3 d、4~7 d不同时期内临床分度与CT分度的相关性。对部分病例进行1个月、3个月及6~24个月的随访观察。结果4~7 d内行CT检查的CT分度与临床分度有明显相关性。1个月复查CT时，脑CT改变与预后密切相关。重度HIE的CT多表现为脑软化、穿通畸形及弥漫性脑萎缩。结论生后4~7 d为新生儿缺氧缺血性脑病的较为合理的检查时间。生后1个月进行CT复查对其预后的判定有较大的价值，可作为HIE预后评估的重要依据之一。脑软化、穿通畸形及弥漫性脑萎缩者预后不良。
关键词缺氧缺血性脑病新生儿多层螺旋CT（MSCT）
Observation and diagnosics of Helical CT on neonate Hypoxic?ischemic encephalopathy
LI Qing?fengHUANG Yue?yanHUANG De?you
ABSTRACTObjectiveTo study the significanc of CT grading and clinic grading in different stage of HIE, searching for a suitable CT examing time and evaluating the value of helical CT for the diagnosis and follow?up of HIE. Methods97 cases with HIE were enrolled. The correlation of CT grading and clinic grading in different stage  of age 1 h?3 d and 4?7 d were reviewed. Some of them were followed?up in one month, three month and 6 to 24 month. RusultsThere was significant correlation of CT grading and clinic grading in age 4?7 days. CT change was correlated to the prognosis in age one month. The CT of severe HIE manifested as encephalomalacia  and porencephaly and diffuse atrophy. ConclusionAge 4?7 days in new born is a suitable CT examing time of neonate HIE. Age one month in new born is valuable for the prognosis, which could be one of the important basises of the prognosis of HIE. Patients with encephalomalacia, porencephaly and diffuse atrophy may have poor prognosis.
KEY WORDSHypoxic?ischemic encephalopathy Neonate Multi?Spiral CT