新生儿蛛网膜下腔出血与正常新生儿颅脑的CT鉴别诊断

CT in differential diagnosis of newborn subarachnoid hemorrhage and normal newborn infants

目的研究新生儿蛛网膜下腔出血(SAH)与正常新生儿颅脑的CT鉴别诊断。方法对比分析85例新生儿SAH与85例正常新生儿的颅脑CT表现,对其影像学特征进行对比分析鉴别。结果85例SAH中发生于直窦27例(31.76%),上矢状窦22例(25.88%),纵裂池14例(16.47%),小脑天幕11例(12.94%),外侧裂池8例(9.41%),脑底池2例(2.35%),小脑延髓池1例(1.18%)。在85例SAH征象中,出现线状征及空三角征49例(57.65%)。85例正常新生儿颅脑相对高密度部位:直窦9例(10.59%),上矢状窦7例(8.24%),纵裂池3例(3.53%),小脑天幕1例(1.18%)。85例SAH患儿,有6例诊断不符。两组CT表现比较差异有显著性(P<0.05)。结论正常新生儿CT表现为直窦、上矢状窦、纵裂池、小脑天幕有时密度相对略高,易误诊为新生儿SAH,因此要注意正常新生儿颅脑与新生儿SAH的CT鉴别。

Objective To study clinical efficacy of brain CT screening for differential diagnosis of newborn infants with subarachnoid hemorrhage （SAH） and normal newborn infants. Methods A comparison of CT presentations between 85 neborns with SAH and 85 normal infants were performed. Their images characteristics were analytically compared. Results The initial sites of 85 cases with SAH were： 27 cases （31.76%） in sinus rectus; 22 cases （25.88 % ） in sinus sagittalis superior; 14 cases （16.47 % ） in longitudinal fissure cistern; 11 cases （12.94 % ） in cerebellar tentorium; 8 cases （9.41% ） in lateral fissure cistern; 2 casses （2.35%） in basis encephali cistern, 1 case （1.1_8%） in cerebellar bulb cistern. The image presentation of 85 cases with SAH were： 49 cases （57.65%） with linear manifestation and hole triangle sign. The relative high density sites in 85 normal newborn infants： 9 cases （ 10.59 % ） in sinus rectus, 7 cases （8.24 % ） in sinus sagittalis superior; 3 cases （3.53 % ） in longitudinal fissure cistern, 1 case （1.18 % ） in cerebellar tentorium. 85 newborns with SAH, 6 cases was not in conformance with diagnosis. In comparison of the CT presentation laetween these two groups, there was statistical difference （ P 〈 0.05）. Conclusion CT sometimes presents with relatively high density in sinus rectus, sinus sagittalis superior, longitudinal fissure cistern and cerebellar tentorium ii, normal newborn infants, which easily diagnosed as newborn SAH. So it should be paied attention to the cranial CT differential diagnosis of normal neworns and newborns with SAH.