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目的分析新生儿缺氧缺血性脑病(neonatal hypoxic-ischemic encephalopathy,HIE)的CT、MRI征象,探讨低场MRI和多层螺旋CT对HIE的早期诊断价值。方法收集2009年12月至2011年8月,临床证实并行颅脑CT或/和MRI检查为HIE的患者26例,男性20例,女性6例;年龄30 min至17 d,平均3.12 d(≤1 d者3例、1～5 d者21例),回顾性分析CT检查17例和MRI检查13例(4例患儿同时进行了CT、MRI检查)资料。结果 10例早产儿的脑部损伤以脑室旁白质水肿、分水岭性脑梗死、脑实质或/和脑室内出血为主,16例足月儿脑部损伤以大脑皮层下旁矢状区白质水肿、分水岭区脑梗死、颅内脑外出血为主;17例CT诊断有14例与临床诊断相符合,符合率82.35%,13例MRI诊断有12例与临床诊断相符合,符合率92.31%。结论多层螺旋CT及低场MRI检查对HIE致脑部损伤包括脑水肿、脑梗死、颅内出血等均有较好的显示能力,临床可根据患儿病情和病程的不同选择CT及MRI检查,达到对HIE早期诊断的目的。
Objective To analyze the CT and MRI features of neonatal hypoxic-ischemic encephalopathy (HIE) and to explore the value of low field MRI and multi-slice spiral CT in the early diagnosis of HIE. Methods From December 2009 to August 2011, 26 patients (20 males and 6 females) with HIE diagnosed by brain CT and / or MRI were collected. The mean age was 3.12 days 1 in 3 cases and 21 cases in 1 ~ 5 days. The data of 17 cases of CT and 13 cases of MRI (CT and MRI examination of 4 cases) were analyzed retrospectively. Results Brain damage in 10 premature infants was mainly left ventricular white matter edema, watershed cerebral infarction, cerebral parenchyma and / or intraventricular hemorrhage. Sixteen infants with full-term brain injury had white matter edema in the paraxial sagittal region of the cerebral cortex, Regional cerebral infarction and intracranial cerebral hemorrhage. Fourteen of 17 CT diagnoses were consistent with clinical diagnosis, with a coincidence rate of 82.35%. Twelve of 13 MRI findings were in accordance with clinical diagnosis, with a coincidence rate of 92.31%. Conclusions Multi-slice spiral CT and low-field MRI can detect brain injury including cerebral edema, cerebral infarction and intracranial hemorrhage in HIE better. The CT and MRI can be selected according to the condition and course of the disease. To achieve the purpose of early diagnosis of HIE.