【摘要】 目的探讨新生儿缺氧缺血性脑病的CT诊断价值及其分度与预后的关系。方法将109例(轻度61例、中度35例、重度组13例)有窒息缺氧病史,临床诊断为HIE的患儿行颅脑CT检查,初次CT扫描时间为生后5h～15天,并按影像分级标准分轻、中、重三度,其中有76例在生后1～6个月内进行了CT复查。结果①109例HIE患儿脑CT平扫均有不同程度的脑水肿征象,CT值在8～18HU之间。诊断为轻度HIE的66例;诊断为中度HIE的为31例,合并颅内出血9例;诊断为重度HIE的为12例,合并颅内出血7例。并将临床分度与CT分度资料经统计学处理进行比较分析,经统计学处理r=0.775,(P<0.01),认为CT分级与临床分级之间有密切的相关性;②随访复查:最后一次CT复查所见,正常45例,单纯脑沟加深13例,硬膜下积液7例,脑软化7例,脑积水3例,脑萎缩3例,死亡2例。结论 CT扫描检查是诊断HIE的主要手段,能够准确的显示病变和范围,确定是否合并颅内出血及出血类型,对HIE脑损伤程度及预后的有较好的评估价值。更多还原

【Abstract】 Objective To explore the diagnostic value of CT in neonates with hypoxic-ischemic encephalopathy(HIE),and the retationship between indexing and the prognosis.Methods The CT examinations were performed in 109 cases(mild group: 61 cases,moderate group: 35 cases,and severe group: 13 cases) of neonates with apneic hypoxia history which were diagnosed by clinic.The initial CT scanning was performed at 5 hours to 15 days after birth.And the CT image grading standards were divided into mild,moderate and severe degree.76 cases were performed CT re-examination within 1~6 month after birth.Results ① 109 HIE neonates showed different degrees of crebral edema symptoms through CT plain film scanning,CT values were between 8~18 HU.66 cases were diagnosed as mild HIE.31 cases were diagnosed as moderate HIE with 9 cases of in-tracranial hemorrhage(ICH).12 cases were diagnosed as severe HIE with 7 cases of in-tracranial hemorrhage.Finally,clinical grading and CT indexing data were compared by statistical methods,and the result showed that r was 0.775,(P<0.01).Furthermore,there was a closely correlation between clinical grading and CT grading;② Follow-up review: last CT reviews showed that 45 cases were normal,13 cases were simple deepened sulcus,7 cases were subdural collection of fluid,7 cases were encephalomalacia,3 cases were hydrocephalus,3 cases were cerebral atrophy,and one case was death.Conclusion CT scan is the primary method in the diagnosis of HIE,which can precisely display lesions and scope,determine whether there was complicated with intracranial hemorrhage and the type of hemorrhage.Moreover,it has better review values of brain injury severity and prognosis of HIE.更多还原