超声动态观察新生儿室管膜下出血

Ultrasonic dynamic observation of neonatal subependymal hemorrhage

目的观察新生儿室管膜下出血(SEH)的超声表现。方法对42例SEH新生儿进行定期颅脑超声检查及随访,并分析其影像学资料。结果超声显示在侧脑室前角外下方及丘脑尾状核沟呈回声增强区,未侵入侧脑室。在出血初始阶段,病灶呈中高度回声;出血稳定期回声渐强、边界更清;吸收期,病灶中央出现低回声而边缘仍为高回声,并逐渐形成透声差、有分隔的厚壁囊腔;随后病灶中央出现无回声区,最终形成出血后室管膜下囊腔。在出院后追踪随访显示,4.76%(2/42)、54.76%(23/42)、23.81%(10/42)的患儿分别在出血1个月、2个月、3个月囊腔消失,3个月内病灶基本吸收的患儿占83.33%(35/42)。结论颅脑超声具有早期诊断SEH的优势,可动态观察病程变化、评估出血转归。

Objective To investigate the ultrasonic manifestations of the neonatal subependymal hemorrhage（SEH）dynamically.Methods Totally 42 neonates of SEH were examined and followed up by cranial ultrasound regularly,and the data were analyzed.Results There were hyperechoic areas bellow the anterior horn of lateral ventricle and in thalamus caudate nuclei ditch,no invading the lateral ventricle.The lesions were high echogenic areas in the initial stage of bleeding,and the echo and boundary of bleeding lesions became stronger and clearer in bleeding stable stage;hypoechoic areas appeared in central lesions while hyperechoic remained peripherally in absorption stage,and the thick-walled cysts with poor transparent sound and separated strips were being formed gradually;then anechoic areas appeared in central lesions and cysts were formed eventually.One month,two months,three months after bleeding,cysts disappeared accounted for4.76%（2/42）,54.76%（23/42）,23.81%（10/42）,respectively.And lesions absorption within 3months accounted for83.33%（35/42）.Conclusion Cranial ultrasound examination has important clinical significance in early diagnosis,observing the course of disease,estimating the absorption of hemorrhage,and directing clinical treatment for neonatal SEH.