新生儿颅内出血的CT诊断（附68例分析）

Newborn skull internal hemorrhage CT diagnosis（attaches 68 example analyses）

目的：分析新生儿颅内出血的CT表现及其形成机制,提高对该病的CT诊断水平.材料与方法：对68例新生儿颅内出血的CT表现进行了回顾性的分析.结果：①蛛网膜下腔出血28例,占41%,为新生儿颅内出血的最常见的类型,表现为：脑池及脑凸面的脑沟铸型高密度灶;②脑实质出血12例,占18%,表现为脑实质内高密度灶;③硬膜下及硬膜外出血10例,占15%：硬膜下血肿表现为颅骨内板下或大脑镰、小脑幕新月形高密度灶,边缘较模糊;硬膜外血肿CT表现为颅骨内板下梭形或双凸镜形高密度灶,内缘光整锐利,其内或可伴有少量积气,常合并为颅骨青枝骨折或线形骨折、头皮血肿.④脑室周围-脑室内出血10例,占15%,多见于早产儿,脑室管膜下出血CT表现为细条状、斑片状高密度灶;脑室内出血表现为沿脉络丛分布的铸型高密度灶或出现液血平面.⑤混合型出血8例,占11%,一般见于临床病症非常严重的患儿,常合并以上两种或三种出血部位的CT表现,预后欠佳.结论：CT扫描能准确提示新生儿颅内出血的出血部位、出血范围,并对制定治疗方案和观察预后具有重要意义.

Objective： Analyzes the newborn skull internal hemorrhage CT to display and to form the mechanism, enhances to the CT diagnosis level which should get sick. Material and Methods： Has carried on the review analysis to 68 example newborn skull in- ternal hemorrhage CT performance. Results：（1）Under the arachnoidea the cavity bleeds 28 examples,accounts for 41 ~, for the new- born skull internal hemorrhage most common type, the performance is： Brain pond and brain convex brain ditch cast high density stove; （2） The brain essence bleeds 12 examples, accounts for 18 %, displays for the brain essence in the high density stove;（3）Under the hard membrane and the hard membrane external hemorrhage 10 examples,account for 15%：Under the hard membrane the haematoma performance for the skull in under the board or the cerebrum sickle, the cerebellum curtain meniscus high density stove, the edge is fuzzy; Outside hard membrane haematoma CT performance for skull in under board spindle-- shaped or biconvex mirror shape high density stove,in reason light entire sharp, among them or may be accompanied by the few pneumatoses,often merges for the skull blue bone fracture or the linear bone fracture,the scalp haematoma. （4）Around the ventricles of the brain -- the ventricles of the brain internal hemorrhage 10 examples, account for 15%, sees in the premature infant, under the brain ependyma bleeds the CT performance for the tall and slender shape, the spot laminated shape high density stove;The ventricles of the brain internal hemorrhage performance for or appears the fluid blood plane along the vein clump of distributed cast high density stove. （5）The mixed type bleeds 8 examples, accounts for 11%, sees generally in the clinical illness extremely serious trouble, often merges above two kind of or three kind of hemorrhage spot CT performance, the prognosis unsatisfactory. Conclusion：The CT scanning can prompt the newborn skull internal hemorrhage accurately the hemorrhage spot, the hemorrhage scope, and to formulates the treatment plan and the observation prognosis has the vital significance.