床旁颅脑超声与磁共振成像在新生儿脑室周围-脑室内出血中的应用对比研究

Comparison of bedside ultrasound and MRI in neonatal peri-intraventricular hemorrhage

目的探讨床旁颅脑超声与磁共振成像(magnetic resonance imaging,MRI)对新生儿脑室周围-脑室内出血(peri-intraventricular hemorrhage,PIVH)的应用价值。方法回顾性分析2016年6月至2019年12月期间收住福建省立医院及福建省立金山医院的103例新生儿疑似PIVH的患儿,103例患儿均行颅脑超声和MRI检查,综合分析检查时长及比较超声/MRI诊断PIVH不同等级的结果。结果①检查时长:颅脑超声检查时长3~6(5.0±2.2)min,MRI检查时长10~19(14.0±3.6)min,两者差异有统计学意义(P<0.05);②根据新生儿PIVH分级,床旁颅脑超声对于PIVH诊断:Ⅰ级76例;Ⅱ级17例;Ⅲ级脑室内出血7例;Ⅳ级脑室内出血3例。MRI对于PIVH诊断:Ⅰ级75例;Ⅱ级18例;Ⅲ级7例;Ⅳ级3例。超声与MRI两种方法得出的诊断结果之间差异没有统计学意义(χ^2=0.035,P=0.998),且两种方法得到的结果具有较高的一致性(Kappa=0.896,P<0.050)。结论床旁颅脑超声检查可作为新生儿PIVH检查的首选方法。

Objective To explore the value of bedside ultrasound and magnetic resonance imaging(MRI)in neonatal peri-intraventricular hemorrhage(PIVH).Methods Data of 103 neonates with PIVH were retrospectively analyzed from June 2016 to December 2019.All patients were examined by bedside ultrasound and MRI.The examination duration and different grades of PIVH based on Papile classification in ultrasound images/MRI images were analyzed.Results①The examination duration of bedside ultrasound was 3~6(5.0±2.2)min,and the examination duration of MRI was 10~19(14.0±3.6)min.The difference between the two imaging methods was statistically significant(P<0.05);②According to the finding of bedside ultrasonography,there are 76 cases of Grade Ⅰ PIVH,17 cases of grade Ⅱ PIVH,7 cases of grade Ⅲ PIVH and 3 cases of grade Ⅳ PIVH.While,the finding of MRI showed that there are 75 cases of GradeⅠPIVH,18 cases of Grade Ⅱ PIVH,7 cases of Grade Ⅲ PIVH and 3 cases of Grade Ⅳ PIVH.There was no statistically significant difference between the results of bedside ultrasound and MRI(χ^2=0.035,P=0.998),and the results of both methods had high consistency(Kappa=0.896,P<0.050).Conclusion Bedside ultrasound can be the first choice for PIVH in neonates.