早产儿围生期窒息颅脑CT表现观察

CT Findings of the Head in Preterm Infants with Perinatal Apnea

目的探析早产儿围生期窒息的颅脑CT表现。方法选取180例围生期窒息新生儿分早产组与足月组,每组90例。比较颅脑CT影像学表现、神经功能及脑白质CT值,脑白质损伤情况。结果早产儿脑室周围白质低密度灶,CT值<16 Hu,显示脑实质密度弥散性下降,且脑室出血或蛛网膜下腔出血;足月儿脑皮质和皮质下白质低密度灶,CT值<18 Hu,大部分出现在两侧额、颞、顶以及枕叶部位,部分合并脑室或蛛网膜下腔出血。与足月组相比,早产组NBNA评分、脑白质CT值均更低,差异具有统计学意义(P<0.05);与轻度窒息组相比,重度窒息组NBNA评分、脑白质CT值均更低,而脑白质损伤率更高,差异具有统计学意义(P<0.05)。结论围生期窒息对不同胎龄新生儿的脑组织病理损伤不同,早产儿组织病变主要集中于脑室周围白质,且窒息越严重,其脑白质损伤也越严重。

Objective To investigate the CT findings of the head in preterm infants with perinatal apnea.Methods Totally 180 neonates with perinatal apnea were selected and divided into preterm group and full-term group with 90 neonates in each group.The CT findings of the head,nerve functions,and CT values of the alba and the condition of alba injury were compared between the two groups.Results In preterm infants,low-density lesions in the periventricular white matter with the CT values<16 Hu showed that the density of brain parenchyma diffusely decreased and there were ventricular hemorrhage or subarachnoid hemorrhage.In term infants,low density lesions of cortex and subcortical white matter with CT value<18 Hu showed that most of them appeared in bilateral frontal,temporal,parietal and occipital lobes and some of them were complicated with intraventricular or subarachnoid hemorrhage.Compared with the full-term group,the preterm group had significantly lower NBNA score and CT value of the alba(P<0.05).In addition,compared with the mild apnea group,the severe apnea group had significantly lower NBNA score and CT value of the alba and significantly higher alba damage rate(P<0.05).Conclusion Perinatal apnea causes different pathological damages of brain tissues in neonates with different gestational ages.The pathological changes of preterm infants mainly concentrated in periventricular white matter,and the more severe the apnea,the more severe the white matter damage.