新生儿缺氧缺血性脑病CT诊断和随访的价值

CT Diagnosis and Follow-up Observation for Anoxic-ischemic Encephalopathy in Neonates

目的 讨论新生儿缺氧缺血性脑病(NAE)的CT诊断和随访的价值。方法 对125例NAE患儿进行头颅CT平扫,分析CT征象。结果 36例CT诊为轻度NAE,表现为大脑实质内有斑片状低密度灶,范围≤2个脑叶;62例诊为中度NAE,病灶分布超过2个脑叶,脑灰白质分界不清,其中25例并发蛛网膜下腔出血;27例为重度NAE,大脑半球呈弥漫低密度,脑室、脑池变窄或消失,其中12例合并脑内出血。随访68例,CT显示26例恢复正常,7例脑白质萎缩,8例脑积水,12例脑灰质萎缩,3例遗留脑软化灶,12例双额部有少量硬膜下积液。结论 CT除能准确诊断NAE外,还可用于随访观察其后遗症。

Objective To evaluate CT diagnosis and follow-upstudy of anoxicischemic encephalopathy in neonates. MethodsThe CT features of 125 cases of anoxic-ischemic encephalopathyin neonates were studied. Results Mild degree of encephalopathywas found in 36 cases showing a low-density patch with a sizenot exceeding 2 lobes.The pathological changes were moderatelyadvanced in 62 cases.The size of the diseased patch exceeded 2lobes and its margin was blurred.There was subarachnoid hem-orrhage in 25 out of the 62 cases.Severe manifestations ofencephalopathy occurred in 27 cases.Low-density patch ex-tended over the cerebral hemisohere and the ventricle andcisterna were narrowed or even disappeared.Intracerebral bleed-ing occurred in 12 out of the 27 cases.Followup observationwith CT revealed;recovery to normal in 26 cases,white matteratrophy in 7,gray matter atrophy in 12,hydrocephalus in 6,encephalomalacia in 3 and smasll amount of subdural effusion ofboth sides in 12. Conclusion In addition to the diagnosis ofanoxic-ischemic encephalopathy,CT can discover the squela ofthe disease.[