新生儿缺氧缺血性脑病CT与临床分度的相关性

Correlation between CT grading and clinical grading of neonatal hypoxic-ischemic encephalopathy

目的研究新生儿缺氧缺血性脑病(HIE)CT与临床分度间的相互关系,并评价CT对预测新生儿HIE预后的意义。方法对169例HIE患儿行头颅CT检查,并对CT结果分为轻、中、重度与HIE临床分度进行对照比较,并对107例患儿复查CT片进行分析。结果CT分度轻度与临床符合率为80.7%,CT中、重度与临床符合率分别为94%、43.7%。本组轻度HIE复查CT时病灶多已吸收,无明显后遗症;中、重度HIE大多数亦可治愈,少数形成外部性脑积水,而且外部性脑积水可以逐步吸收直至痊愈。结论HIE患儿头颅CT分型与临床分度有一定相关性,但也有差异性,两者综合评价可作出较明确诊断,为临床的早期治疗提供重要依据。CT对HIE预后评估有重要价值。

Objective To investigate the correlation between CT grading and clinical grading of neonatal hypoxic-ischemic encephalopathy （HIE） and to evaluate the significance of CT grading for predicting the prognosis of neonatal HIE. Methods A hundred and sixty-nine neonate with HIE underwent CT scans of the head.The CT findings of all neonate were divided into mild,moderate and severe HIE according to CT grading and compared with those of clinical grading ,simuhaneously,CT findings of 107 neonate who underwent CT reexamination were together analyzed. Results The corresponding rates between CT grading and clinical grading for mild,moderate and severe HIE wen 80.7% ,94% and 43.7% respectively.When HIE neonate CT reexaminations,the most mild HIE lesions have been absorbed and no obvious sequelae were found.Most moderate and severe HIE lesion were found also to be cured.Only several HIE lesions were found to have the formation of external hydrocephalus,however, the external hydrocephalus could be also gradually absorbed until healed. Conclusion CT grading of neonatal HIE is close correlated with clinical grading but has certain difference between the both.The comprehensive evaluation of the both modalities may make a definite diagnosis of this diease and may provide valuable evidence for early treatment,in addition,CT grading plays important role in the evaluation of HIE prognosis.