经颅超声诊断新生儿脑室周围-脑室内出血343例分析

Analysis of neonatal periventricular-intraventricular hemorrhages by cranial ultrasounography

目的:分析经颅超声诊断高危新生儿脑室周围脑室内出血(PIVH)的超声表现。方法:对2006年7月～2008年2月在我院住院的817例高危新生儿应用新生儿颅脑专用探头行经颅超声检查,并对结果进行回顾性分析。结果:发观PIVH 343例(42.0%)。Ⅰ度PIVH 69例,表现为尾状核头区团块,病灶较小。Ⅱ度PIVH 233例,可见脑室内强回声团块,不伴有脑室扩张。Ⅲ度PIVH 35例,除脑室内强回声团块外可见脑室扩张。Ⅳ度PIVH 6例,除具有Ⅲ度表现外可见脑实质内出血团块。出血病灶首次检测呈强回声区233例(67.9%),呈低回声区72例(21.0%),出现囊腔38例(11.1%)。结论:经颅超声对PIVH临床诊断有重要意义,可作为诊断PIVH的首选方法。

Objective： To evaluate the diagnostic value of cranial ultrasounography for neonatal periventricular-intraventricular hemorrhages （PIVH）. Methods： Cranial ultrasounography examinations were performed in 817 newborn infants with high risk factors including premature infants and infants with asphyctic history. Those infants with PIVH were separated from four grades. Results： Three hundred and forty three newborn infants （43%） were detected as PIVH. In sonogram： Grade Ⅰ of PIVH （20.1%） showed as small bolus in the area of the head of caudate nucleus. Grade Ⅱ of PIVH （67.9%） showed as intraventricular hyperechoic bolus not accompany with dilation of the ventricle. Grade Ⅲ of PIVH （10.2%） showed as intraventricular hyperechoic bolus accompany with dilation of the ventricle. And grade Ⅳ of PIVH （1.8%） showed as the feature of grade Ⅲ of PIVH and cerebral intraparenchymatous hemorrhagic bolus. There were various appearance of hemorrhagic bolus detected at first time. 67.9% of hemorrhagic bolus showed as hyperechoic area. 21.0% of hemorrhagic bolus showed as hypoechoic area. 11.1% of hemorrhagic bolus showed as anechoic area. Conclusions： Cranial ultrasounography has important significance for the evaluation of PIVH. It can be chosen as a valuable tool for the diagnosis of PIVH.