多普勒超声对新生儿单侧室管膜下病变诊断价值的研究

The value of diagnosing neonate unilateral subependymal lesions by Doppler ultrasound

目的:探讨多普勒超声对新生儿单侧室管膜下病变的早期诊断及鉴别诊断的临床应用价值。方法:回顾性分析140例新生儿生后1周内颅脑超声检查结果,分析各组间大脑中动脉(MCA)的收缩期末最大血流速度(Vs),舒张期末最大血流速度(Vd)及阻力指数(RI)的变化。结果:140例新生儿,正常对照组50例,单侧室管膜下出血组50例,出血液化组20例,单侧室管膜下囊肿20例。室管膜下囊肿患侧的MCA血流速度(Vs、Vd)均高于正常对照组(P<0.05),患侧Vs高于健侧(P<0.05)。室管膜下囊肿的患侧MCA血流速度(Vs、Vd)均明显高于室管膜下出血组侧(P<0.05)。室管膜下出血液化组的患侧MCA的血流速度(Vs)明显低于囊肿组(P<0.05)。结论:出生1周内新生儿单侧室管膜下病变的MCA血流参数变化有一定的特征,二维超声结合频谱多普勒动态监测MCA的血流参数可鉴别诊断室管膜下出血液化及室管膜下囊肿,并可预测室管膜下出血的病程发展,有利于指导后续的干预治疗。

Objective ： To explore the diagnosis value of neonate unilateral subependymal lesions by Doppler ultrasound. Methods： To analyze retrospectively the brain ultrasound results in 140 cases within one week after birth. The systolic velocity （Vs） , diastolic blood velocity （Vd） and resistance index （RI） of middle cerebral artery （MCA） were compared and analyzed. Results： In the 140 cases, there were 50 cases of normal neonatal, 50 cases with unilateral subependymal hemorrhage, 20 cases with unilateral subependymal hemorrhage liquefaction and 20 cases with unilateral subependymal cysts. In unilateral subependymal cysts group, Vs of MCA on involved side was higher than that on no involved side （ P 〈 0. 05 ） ; Vs and Vd of MCA on involved side in unilateral subependymal cysts group were higher than those in normal neonatal group and unilateral subependymal hemorrhage group （ P 〈 0. 05 ） , Vs of MCA on involved side in unilateral sub- ependymal cysts group was lower than that on involved side in unilateral subependymal cysts group （ P 〈 0. 05 ） . Conclusion： Within one week the changes of MCA hemodynamic has certain characteristics with unilateral lesions Subependymal. The monitoring of the changes of MCA hemodynamic by two - dimensional ultrasound combined with Doppler ultrasonography can identify the diagnosis of subependymal hem- orrhage liquefaction and cysts, can still detect the course of subependymal hemorrhage and is beneficial to guide the follow - up treatment .