Neonatal hypoxic-ischemic encephalopathy: Multimodality imaging findings
Neonatal hypoxic-ischemic encephalopathy: Multimodality imaging findings
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DOI：
10.1148/rg.26si065504
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发表时间：
2006-10-01
期刊：
影响因子：
5.5
通讯作者：
Patton, Alice C.
中科院分区：
文献类型：
--
作者：
Chao, Christine P.;Zaleski, Christopher G.;Patton, Alice C.
新生儿弥漫性缺氧缺血性脑损伤可导致新生儿缺氧缺血性脑病（HIE）。由于损伤时脑成熟度、低血压的严重程度和损伤持续时间的不同，脑损伤有四种不同的模式。颅超声和计算机断层扫描显示脑室周围白质软化、生发基质出血和脑积水。磁共振成像是评估脑损伤模式最敏感的方法。在早产儿中，轻度低血压可引起心室周围损伤；严重的低血压导致深灰质、脑干和小脑梗塞。在足月新生儿中，轻度低血压可引起矢状旁皮层和皮层下损伤；严重低血压引起丘脑外侧、后壳层、海马、皮质脊髓束和感觉运动皮层的特征性损伤。及时识别这些影像学表现有助于排除脑病的其他原因，影响预后，并促进早期（尽管大多是支持性的）治疗。
Diffuse hypoxic-ischemic brain injury in the neonate results in neonatal hypoxic-ischemic encephalopathy (HIE). Because of differences in brain maturity at time of insult, severity of hypotension, and duration of insult, there are four distinct patterns of brain injury. Cranial ultrasonography and computed tomography reveal periventricular leukomalacia, germinal matrix hemorrhage, and hydrocephalus. Magnetic resonance imaging is the most sensitive modality for evaluating the patterns of brain injury. In preterm neonates, mild hypotension causes periventricular injury; severe hypotension results in infarction of the deep gray matter, brainstem, and cerebellum. In term neonates, mild hypotension causes parasagittal cortical and subcortical injury; severe hypotension causes characteristic injury of the lateral thalami, posterior putamina, hippocampi, corticospinal tracts, and sensorimotor cortex. Prompt recognition of these imaging findings can help exclude other causes of encephalopathy, affect prognosis, and facilitate earlier ( although mostly supportive) treatment.