对新生儿缺氧缺血性脑病头颅CT脑白质低密度评估的进一步探讨

Evaluation of CT Cerebral White Matter Hypodensity in Neonatal Hypoxic ischemic Encephalopathy.

目的 为比较正常新生儿和缺氧缺血性脑病（ＨＩＥ） 患儿脑白质密度ＣＴ 值，并观察脑白质低密度形态改变与临床分度的关系。 方法 ３０ 例正常新生儿及８１ 例ＨＩＥ 患儿作为研究对象。 结果 （１）３０ 例正常新生儿脑白质ＣＴ 值为１８ ～２８ Ｈｕ，ＨＩＥ３６ 例为５ ～１９ Ｈｕ，χ２ ＝ ６２ ．１ ，Ｐ＜ ０．０１。（２）４５ 例ＨＩＥ患儿中，轻度、中度及重度ＨＩＥ 其脑白质形态改变的发生率分别为３５－７％ ，９０ ％ 及１００ ％ 。１７ 例中、重度ＨＩＥ中有６ 例ＣＴ 值均大于１８ Ｈｕ，但均有中到重度的形态改变。 结论 只有将白质低密度的范围、程度（ＣＴ 值） 及脑白质低密度形态改变三者结合起来分析，ＣＴ

Objective To compare CT value of cerebral white matter in normal and HIE neonates and to observe the relation between shape of white matter hypodensity and clinical feature of HIE. Methods Thirty normal neonates and 81 HIE neonates were studied prospectively. Results (1) CT value of white matter in 30 normal and 36 HIE neonates were 18～28 Hu and 5～19 Hu respectively ( χ 2 =61.1, P =<0.01)。(2) The rates of abnormal shape of cerebral white matter hypodensity in mild, moderate and severe cases of 45 HIE neonates were 35.7%, 90% and 100% respectively. CT values in 6 of 17 moderate and severe HIE cases were >18Hu, but all of them had moderate and severe shape changes. Conclusion Brain damage shown by CT can be diagnosed properly only by combination of the CT value, range and shape of cerebral white matter hypodensity.