MSCT诊断新生儿缺血缺氧性脑病的效能及预后评估效果

The diagnostic efficacy and prognosis evaluation of MSCT in the diagnosis of neonatal hypoxic ischemic encephalopathy

目的探讨多层螺旋CT(MSCT)在新生儿缺血缺氧性脑病中的诊断效能及预后评估效果。方法回顾性分析本院2018年1月至2019年12月收治的156例新生儿缺血缺氧性脑病患儿的MSCT诊断资料,将临床表现分度作为金标准,进行对比,明确在该疾病中MSCT的诊断效能及患儿预后3个月发育情况。结果156例患儿根据临床表现分度判定分为轻度缺血缺氧性脑病80例、中度50例、重度26例,MSCT诊断确诊135例,MSCT精准率分别为:86.3%(69/80)、84.0%(42/50)、92.3%(24/26)。MSCT影像学资料显示2个以下脑叶损伤为80例,2个及2个以上脑叶损伤76例;外部脑积水40例,基底节病变20例,单纯蛛网膜下腔出血40例,颅内多部位出血56例。预后3个月随访时有47例(30.1%)患儿的发育水平指标-发育商(DQ)<90,109例(69.9%)患儿DQ≥90。结论MSCT具有无创安全、操作简便、快捷可重复、分辨率高、辐射剂量小等优势,能够快速明确患儿病灶所处位置、形态、损伤程度及损伤范围,给予及时干预,提升患儿预后发育指标,具有极高的临床使用价值。

Objective To investigate the diagnostic efficacy and prognosis evaluation of MSCT in neonatal hypoxic ischemic encephalopathy.Methods The MSCT diagnostic data of 156 neonates with hypoxic ischemic encephalopathy treated in our hospital from January 2018 to December 2019 were retrospectively analyzed.With the clinical manifestations as the gold standard,the diagnostic efficacy of MSCT in this disease and the prognosis of the children at 3 months of developmentwere determined.Results According to the clinicalmanifestations,therewere 80 cases of mild neonatal hypoxic ischemic encephalopathy,50 moderate cases,and 26 severe cases of 156 children,among them 135 cases were diagnosed by MSCT,the accuracy of MSCT was 86.3%(69/80),84.0%(42/50),92.3%(24/26),respectively.MSCT imaging data showed that therewere 80 caseswith less than 2 lobe injuries,76 caseswith 2 ormore lobe injuries;40 caseswith external hydrocephalus,20 cases with basal ganglia lesions,40 cases with subarachnoid hemorrhage alone,and 56 cases with intracranial multi-site hemorrhage.At 3-month follow-up,there were 47 children with development quotient(DQ)lower than 90,accounting for 30.1%,and 109 children with DQ equal to or above 90,accounting for 69.9%.Conclusion MSCT has the advantages of non-invasive,safety,simple operation,quick repeatability,high resolution,and lowradiation dose.It can quickly determine the location,shape of lesions,damage degree and damage range of children,timely intervention can improve the prognosis and development indicators of children,and has extremely high clinical application value.