CT、MRI在新生儿缺氧缺血性脑病中的诊断价值

Diagnostic value of CT,MRI in neonatal hypoxic ischemic encephalopathy

目的：探讨CT和MRI在新生儿窒息后缺氧缺血性脑病的诊断价值。方法分析我院2011年1月～2013年10月收治的42例新生儿，均有明确的窒息史，且确诊为新生儿缺氧缺血性脑病（HIE），应用CT和MRI两种方法进行检测。结果 MRI总体检出率为97.6%（41/42），CT总体检出率为90.5%（38/42），两组比较差异无统计学意义（x2=1.91，P＞0.05）。MRI、CT总体检出率分别为脑水肿100.0%（30/30），93.3%（28/30）；脑室出血检出率为100.0%（7/7），85.7%（6/7）；基底核丘脑损伤检出率为50.0%（1/2），100.0%（2/2）；矢状旁区损伤100.0%（1/1），100.0%（1/1）；脑动脉梗死100.0%（2/2），50.0%（1/2）。结论CT和MRI均可诊断新生儿缺氧缺血性脑损伤，对脑水肿、脑室出血、矢状旁区损、脑动脉梗死初诊可以选择MRI诊断，对于基底核丘脑损伤检出率为初诊可以选择CT，必要时可以两种诊断方面联合诊断以提高临床诊断率。

Objective To investigate the value of CT and MRI in the diagnosis of hypoxic ischemic encephalopathy in neonates with asphyxia. Methods 42 cases of newborn in our hospital from 2011 January to 2013 October were detected. All cases had a clear history of asphyxia, and confirmed the diagnosis of neonatal hypoxic ischemic encephalopathy（HIE）, the application of CT and MRI were detected on HIE. Results The total detection rate of MRI was 97.6%（41/42）, CT detection rate was 90.5%（38/42）, the comparison between the two groups was not statistically significant difference（x2=1.91, P〉0.05）. MRI, CT overall detection rates of cerebral edema were 100%（30/30）, 93.3%（28/30）;ventricular hemorrhage rates were 100%（7/7）, 85.7%（6/7）;basal ganglia thalamic damage detection rates were 50%（1/2）, 100%（2/2）; parasagittal area loss rates were 100%（1/1）, 100%（1/1）; cerebral artery infarction rates were 100%（2/2）, 50%（1/2）. Conclusion CT and MRI can diagnosis of neonatal hypoxic ischemic brain damage, the brain edema, intraventricular hemorrhage, parasagittal area loss, cerebral artery infarction patients can choose MRI, choose CT for basal ganglia thalamic damage detection rate of newly diagnosed, use two kinds of diagnosis to improve the diagnostic rate of combined diagnosis when necessary.