头颅MRI与B超在早产儿脑损伤诊断中的对比研究

The comparative study of cranial MRI and B ultrasound diagnosis of brain injury in preterm infants

目的通过头颅MRI与B超在早产儿脑损伤诊断中的对比研究,探讨头颅MRI、B超对早产儿脑损伤的诊断价值。方法对2010年l月至2011年12月期间,南方医院新生儿科收治的152例早产儿,住院期间行头颅MRI、B超检查,用配对χ2检验比较两种检查方法有无差异,比较各自诊断的准确性与敏感性。结果头颅MRI、B超对早产儿脑损伤的诊断存在显著差异(χ2=27.119,P<0.001),MRI与B超诊断的准确性分别为94.1%、67.1%,敏感性分别为90.0%、44.4%,对IVH诊断一致率为85.16%,新生儿缺氧缺血性脑(HIE)诊断一致率47.83%,脑白质软化(PVL)诊断一致率为33.3%,B超未能发现蛛网膜下腔出血(SAH)、硬膜下出血(SDH)、小脑出血(ICEH)。结论头颅B超显示IVH强于MRI,但B超对HIE、PVL的诊断逊于MRI,B超容易漏诊合并有SAH、SDH、ICEH的脑损伤,B超只可作为初诊、随访追踪的方法。

Objective ： Comparative study crania[ MRI and B ultrasound, to discuss the value of cranial MRI, B ultrasound in diagnosis of brain injury in preterm infants. Methods ： Cranial B Ultrasound and MRI examination were performed on 152 premature infants who were admitted into neonatology in Nan Fang hospital from Jan. 2010 to Dec. 2011. Pairedx2 test was used to compare the two methods whether had difference, compare their diagnostic accuracy and sensitivity. Results： There was a significant difference in MRI, B ultrasound diagnosis of brain injury in preterm infants （ χ2 = 27. 119, P 〈 0. 001 ）. The accuracy of MRI and B ultrasound were 94. 1% , 67. 1%, sensitivity was 90.0%, 44. 4%. IVH diagnostic accordance rate was 85.16% , HIE diagnostic accordance rate was 47. 83%, PVL consistent diagnostic rate was 33.3%. B ultrasound failed to find SAH, SDH, ICEH. Conclusion： B Ultrasound showed IVH was stronger than MRI, showed HIE, PVL worse than MRI, easily missed brain injury associated with SAH, SDH, ICEH. B ultrasound only can be used as first visit and follow - up method.