Early diagnosis and outcome prediction of neonatal hypoxic-ischemic encephalopathy with color Doppler ultrasound
Early diagnosis and outcome prediction of neonatal hypoxic-ischemic encephalopathy with color Doppler ultrasound
复制标题
DOI：
10.1016/j.diii.2016.12.001
复制
发表时间：
2017-06-01
影响因子：
5.5
通讯作者：
Liu, H.
中科院分区：
文献类型：
--
作者：
Guan, B.;Dai, C.;Liu, H.
目的：探讨新生儿缺氧缺血性脑病（HIE）的超声表现及脑血流动力学，并与对照组进行比较。材料与方法：选取2012年6月至2013年4月期间有HIE临床证据的足月新生儿为研究对象。未患HIE的健康新生儿作为对照组。采用二维双工及彩色多普勒超声检查脑实质、侧脑室大小及脑动脉血流动力学参数。对中重度HIE患儿进行至少3个月的超声随访。结果：共纳入158例新生儿（男82例，女76例），其中轻度HIE 54例，中度HIE 60例，重度HIE 44例。随机选取120名健康新生儿作为对照组。超声显示脑实质异常在轻度HIE患儿中占25/54(46.3%)，在中度HIE患儿中占58/60(96.7%)，在重度HIE患儿中占44/44（100%）。重度HIE患儿几乎均出现脑动脉血流速度下降、脑动脉阻力指数升高的现象。104例中重度HIE患儿中，随访超声检查发现12/104患儿出现囊性实质病变（11.5%），12/104患儿出现进行性脑室扩张和脑萎缩（11.5%），15/104患儿出现轻度脑室扩张（14.4%），2/104患儿出现脑白质软化（1.9%）。结论：侧脑室大小、脑实质回声改变、脑血流参数等超声特征有助于HIE的早期诊断和预后预测。(C) 2016版法国放射学。Elsevier Masson SAS出版。版权所有。
Purpose: To describe the ultrasound presentation of the brain and cerebral hemodynamics in neonates with hypoxic-ischemic encephalopathy (HIE) by comparison with control subjects.Material and methods: During June 2012 to April 2013, full term neonates who had clinical evidence of HIE were enrolled. Healthy newborns without HIE were used as a control group. Cerebral parenchyma, size of lateral ventricles and hemodynamic parameters of cerebral arteries were studied using two-dimensional duplex and color Doppler ultrasound. Neonates with moderate and severe HIE were followed-up with ultrasound for at least 3 months.Results: A total of 158 consecutive neonates (82 boys and 76 girls), including 54 with mild HIE, 60 with moderate HIE and 44 with severe HIE were included. One hundred and twenty healthy newborns were randomly selected as a control group. Abnormal ultrasound findings of brain parenchyma were found in 25/54 (46.3%) neonates with mild HIE whereas they were found in 58/60 (96.7%) neonates with moderate HIE and 44/44 (100%) neonates with severe HIE. Almost all neonates with severe HIE had decreased cerebral artery blood flow velocity and increased resistance index of cerebral arteries. Of the 104 neonates with moderate or severe HIE, follow-up ultrasound examination revealed cystic parenchymal lesions in 12/104 (11.5%), progressive ventricular dilatation and brain atrophy in 12/104 (11.5%), mild ventricular dilatation in 15/104 (14.4%) and leukoencephalomalacia in 2/104 (1.9%) neonates.Conclusion: Ultrasound features such as the size of lateral ventricles, altered brain parenchymal echogenicity and cerebral blood flow parameters are useful for the early diagnosis of HIE and help predict outcome. (C) 2016 Editions francaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.