头颅超声与MRI对新生儿颅内出血诊断的价值分析

Diagnostic Value of Cranial Ultrasound and MRI in Neonatal Intracranial Hemorrhage

目的:比较头颅超声与MRI技术对新生儿颅内出血的临床诊断价值。方法:对本院超声科100例疑似新生儿颅内出血(2015年7月1日-2018年6月30日收治)患儿进行观察研究,所有患儿均进行头颅超声和MRI检查,观察并记录病灶数、病灶分布情况,分析比较两种检测技术的诊断效果。结果:MRI检查对脑实质出血检出率95.0%、蛛网膜下腔出血检出率93.8%、新生儿颅内出血总检出率93.0%,均明显高于超声检查的65.0%、56.3%和79.1%(P<0.05)。MRI检查对1级脑室出血患者的检出率60.0%,显著低于超声检查的100%(P<0.05)。MRI检查对新生儿颅内出血病灶检出率90.2%,显著高于超声检查的76.5%(P<0.05)。MRI检查对新生儿颅内出血的敏感度为93.0%、准确率为94.0%,均明显高于超声检查的79.1%和82.0%(P<0.05)。结论:MRI检查对新生儿颅内出血诊断效果总体优于头颅超声检查,而头颅超声检查对低等级脑室内出血诊断时,具有MRI诊断无法取代的优势,因此头颅超声与MRI联合运用将有助于提升诊断效果。

Objective:To compare the diagnostic value of cranial ultrasound and MRI in neonatal intracranial hemorrhage.Method:100 cases of suspected neonatal intracranial hemorrhage(treated from July 1,2015 to June 30,2018)in Department of Ultrasonography of our hospital were observed and studied. All children were examined by cranial ultrasound and MRI.The diagnostic effect of two detection methods and the detection results of the number and distribution of the lesions in children were analyzed and summarized. Result:The detectable rate of cerebral parenchyma hemorrhage,subarachnoid hemorrhage and total detection rate of intracranial hemorrhage in neonates of MRI were 95.0%,93.8% and 93.0%,which were significantly higher than 65.0%,56.3%,79.1% of ultrasound(P<0.05).The detection rate of grade 1 intraventricular hemorrhage of MRI was 60.0%,which was significantly lower than 100% of ultrasound(P<0.05).The detectable rate of intracranial hemorrhage in neonates of MRI was 90.2%, which was higher than 76.5% of ultrasound(P<0.05). The sensitivity and accuracy of MRI for neonatal intracranial hemorrhage were 93.0% and 94.0%,which were significantly higher than 79.1% and 82.0% of ultrasound(P<0.05).Conclusion:The overall diagnostic effect of MRI in neonates with intracranial hemorrhage is better than that of cranial ultrasound,but it has an advantage that MRI can not be replaced in the diagnosis of low grade ventricular hemorrhage.Therefore,cranial ultrasound and MRI can be combined to improve the diagnostic effect.