新生儿脑室内及脑室周围囊性病变的超声诊断及与胎龄的关系

Ultrasonographic diagnosis of intraventricular and periventricular cystic lesions in neonates and its relationship with gestational age

目的分析新生儿脑室内及脑室周围囊性病变声像图特征,归纳其发生种类,探讨其与胎龄的关联。方法对2012年8月~2016年5月哈尔滨医科大学附属第一医院新生儿科收治有高危因素的974例早产儿、428例足月儿及同时期无高危围产因素孕妇分娩的200例足月新生儿进行颅脑超声观察,分析脑室内及脑室周围囊性病变的构成、分布及声像图特征,及其发生种类与胎龄的相关性。结果(1)早产组侧脑室前角囊肿(FHC)17例,室管膜下囊肿(SEC)病例31例,脉络丛囊肿(CPC)病例8例,脑白质软化(PVL)0例;(2)足月组FHC 3例,SEC 61例,CPC 3例,PVL 0例;(3)对照组FHC 0例,SEC 9例,CPC 1例,PVL 0例;(4)FHC、CPC的发生与胎龄的关系不显著,P>0.05;SEC的发生与胎龄有显著关联,P<0.001。结论 FHC、SEC及CPC是新生儿颅脑超声中所常见的脑室内及脑室周围的囊性病变。新生儿病房收治的足月儿发生SEC的风险最高。

Objective To analyze intraventricular and periventricular cystic lesions of neonatal cranial sonographic features, summarize its occurrence of species, investigate its association with gestational age. Methods High-risk-factor 974 preterm infants were involved, 428 term infants in the neonatal intensive care unit of the First Affiliated Hospital of Harbin Medical Uni- versity and 200 term neonates who had no high-risk perinatal factors during the same period were enrolled in the hospital from August 2012 to May 2016. Intraventricular and periventricu- lar cystic lesions around the composition, distribution and sonographic features, and the occur- rence of species and gestational age correlation were analyzed. Results Seventeen cases of frontal horn cyst （ FHC）, 31 cases of subependymal cyst （ SEC）, 8 cases of choroid plexuscyst （CPC） , and 0 case of PVL were found in the preterm infant group. Three cases of FHC, 61 cases of SEC, 3 cases of CPC, and 0 case of PVL were found in the term infant group. Zero case of FHC, 9 cases of SEC, 1 cases of CPC, and 0 case of PVL were found in the group without high risk factors. FHC and CPC were not significantly correlated with gestational age, P 〉 0.05. The occurrence of SEC was significantly correlated with gestational age, P 〈 0. 001. Conclusion FHC, SEC and CPC are cystic lesions in the ventricles and periventricles that are common in neonatal brain ultrasound. The INCU term infants have the hightest risk of SEC.