婴儿晚发性维生素K缺乏并颅内出血的CT和MRI表现特点及预后

CT and MRI features and prognosis of late-onset of vitamin K deficiency with intracranial hemorrhages in infants

目的:讨论婴儿晚发性VitK缺乏(VKD)并颅内出血的CT和MRI表现特点及预后。方法:对1999年1月-2002年12月我院经CT确诊的78例VKD并颅内出血的婴儿进行了追踪复查,分析其CT和MRI表现特点。结果:本组78例中蛛网膜下腔出血(SAH)58例(74.4%),硬膜下出血(SDH)41例(52.5%),脑实质出血(IPH)31例(40.0%),脑室内出血(IVH)23例(29.5%)。单一部分出血45例(57.7%),2个部位出血19例(24.4%),3个以上部位出血14例(17.9%)。31例IPH随访复查死亡9例,仅4例恢复正常,其他病人均有脑室扩大、脑软化、脑萎缩、脑钙化形成等不可逆性后遗症的表现,以单纯SAH预后最好,24例1个月复查均恢复正常。结论:不同部位、不同类型的VKD并颅内出血其预后有一定的差别。

Objective： To discuss the CT and MRI features and the prognosis of late-onset of vitamin K deficiency（VKD） with intracranial hemorrhage in infants. Methods： The CT and MRI features of VKD with intracranial hemorrhage were analyzed and follow-up was performed in 78 cases whose diagnoses were confirmed by CT in our hospital from January, 1999 to December, 2002. Results： Of all the 78 cases, 58 cases（74.4%） were associated with subarachnoid hemorrhage（SAH）, 41 cases （52.5%） with subdural hemorrhage（SDH）, 31 cases（40.0%） with intraparenchymal hemorrhage（IPH）, 23 cases（29.5%） with intraventricular hemorrhage（IVH）. Nineteen cases（24.4%） bleeded in two parts of the above, 14 cases （17.9%） in three or more parts of the above. Of the 31 cases with IPH, nine were dead, only four were normal, and the others were suffered from irreversible changes such as ventricular dilation, encephalomalacia, cerebral atrophy or calcium deposition in the follow-up studies. Of all the types of hemorrhage, the prognosis of SAH was the best, 24 cases with SAH were normal in the follow-up studies after one month of the bleeding onset. Conclusion： Different types of intracranial hemorrhage have different prognosis.