早产儿脑室周围回声增强提示脑白质软化的临床价值

The analysis of clinical value with premature periventricular echoenhance in periventricular leukomalacia

目的探讨早产儿床旁颅脑超声在脑室周围回声增强(periventricular echoenhance PVE)方面提示脑白质软化(periventricular leukomalacia PVL)的临床价值。方法应用床旁超声机对本院NICU 2017年1月～2018年1月收入的早产儿行颅脑超声检查,将261例早产儿经首次颅脑超声诊断为脑室周围回声增强的纳入本研究范围。同时根据脑室周围强回声情况进行分级,并对高度怀疑有白质软化患儿行头颅MRI确诊。结果脑室周围回声强度分为:Ⅰ度175例,Ⅱ度60例,Ⅲ度26例;并行临床治疗后再经颅脑超声复查,回声增强区在7 d内消退者123例,8～14 d内消退者62例,15～28 d内消退者56例,28 d后检查有20例患儿脑室周围强回声未消退,并出现了小囊腔变化,经MRI确诊为脑白质软化。结论床旁颅脑超声可清楚显示早产儿脑室周围回声增强的动态情况,对判断脑白质损伤具有重要临床诊断价值。

Objective To explore the clinical value with premature periventricular echoenhance （PVE） in periventricular leukomalacia （PVL） by ultrasound. Methods Premature infants of neonatal intensive care unit （NICU） execute brain ultrasound examination at bedside, and 261 premature infants were included in our study area, who were diagnosed with ventricular echo enhancement（PVE） at first brain ultrasound examination, from January 2017 to January 2018 in our hospital. At the same time, they were graded according to the periventricular echo, and premature infants highly suspected of PVL would be diagnosed by head MRI. Results The 175 cases were classified as PVE I, 60 cases as PVE II and 56 cases as PVE III. And carries on the clinical treatment, PVE faded away within 7 days in 123 cases, 8-14 days in 62 cases and 15-28 in 56 cases, which lasted more than 28 days in 20 cases with cystic appeared in the PVE area were diagnosed to PVL by MRI. Conclusion Brain ultrasound examination at bedside can clearly reflect the dynamic echo intensity of PVE,which has significantly value of clinical diagnosis in accessing the PVL.