住院早产儿头颅SCT分析

Analysis of Head SCT for Inpatients of Premature Infant

目的探讨早产儿头颅SCT表现及特点。方法对200例早产儿头颅SCT检查结果及窒息、实际胎龄的关系进行分析。结果①本组早产儿脑实质密度较正常足月儿低,头颅低密度发生率具普遍性(100%)。②窒息组中低密度值≤6Hu者为97例,占85.7%。③早产儿实际胎龄越小,头颅CT分度越重(P<0.05)。④本组颅内出血:SAH62例,IPH10例,IVH8例,SDH3例。⑤本组HIE病灶分布:双额叶96例,双颞叶40例,双顶叶6例,枕叶15例。⑥HIE合并颅内出血:SAH5例,IVH5例,IPH8例,SDH3例。结论①头颅CT低密度改变为早产儿固有特点,有窒息史可使脑白质密度更低,早产儿实际胎龄越小,低密度范围分布越广泛,头颅CT分度越重。②早产儿颅内出血部位依次为:SAH、IPH、IVH、SDH等。③诊断早产儿HIE头颅低密度≤16Hu为合适。④HIE病灶首先累及双额叶,其次为顶叶、颞叶、枕叶。⑤HIE合并SAH最常见,中、重度HIE合并颅内出血发生率高,轻度HIE较少。

Objective To investigate the CT findings and features of premature infants. Methods The relationship between the results of SCT examination for 200 cases of inpatients of premature infant and asphyxia and actual gestational age was analyzed. Results （1）The cerebral density in premature infant was lower than that in normal term infant. The low density change of premature infant was generally occurred （ 100% ）. （2）In asphyxial group, 97 cases the numerical number of low density ≤ 16Hu（ 85.7% ）. （3）The smaller the actual gestation in premature infant was,the more severe degree the head CT showed （P 〈 0. 05 ） . （4）The distribution of intracranial hemorrhage in study group was-62 cases in SAH, 10 cases in IPH,8cases in IVH,3 cases in SDH. （5）The distribution of HIE lesion was： 96 cases in double frontal lobe ,40 cases in double temporal lobe,6 cases in parietal lobe, 15 cases in occipital lobe. （6）The distribution of HIE with intracranial hemorrhage was：5 cases in SAH,5 cases in IVH,8 cases in IPH,3 cases in SDH. Conclusion （1）The low density change of skull CT was the characteristic of premature infant. Asphyxia made the numerical number of low density in cerebral white matter more lower. The smaller the actual gestation in premature infant was, the more extensive range the low density distributed, the more severe degree the skull CT showed. （2）The area of intracranial hemorrhage in premature infant was SAH, IPH, IVH SDH in turn. （3）To diagnose HIE, the numerical number of low density ≤16 Hu was optimum. （4）The double frontal lobe was first involved by HIE lesions ; next is parietal lobe, temporal lobe, occipital lobe. （5）HIE with SAH was the most. The incidence of moderate and severe HIE with intracranial hemorrhage is high. The mild HIE was less.