PRECISION OF ULTRASOUND DIAGNOSIS OF PATHOLOGICALLY VERIFIED LESIONS IN THE BRAINS OF VERY PRETERM INFANTS

PRECISION OF ULTRASOUND DIAGNOSIS OF PATHOLOGICALLY VERIFIED LESIONS IN THE BRAINS OF VERY PRETERM INFANTS
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DOI：
10.1111/j.1469-8749.1988.tb04773.x
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发表时间：
1988-08
期刊：
Developmental Medicine & Child Neurology
影响因子：
3.8
通讯作者：
P. Hope;S. Gould;Susan Howard;P. Hamilton;A. Costello;E. Reynolds
P. Hope;S. Gould;Susan Howard;P. Hamilton;A. Costello;E. Reynolds
中科院分区：
医学2区
文献类型：
--
作者：
P. Hope;S. Gould;Susan Howard;P. Hamilton;A. Costello;E. Reynolds

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通过机械扫描仪检测到的异常与56名出生时不到33周的婴儿的尸检结果进行了“盲”比较。在112个半球中，有53个半球发现了脑室内出血，并通过超声进行了准确诊断（敏感性91%;特异性81%）。孤立性生发层出血识别不太成功（敏感性61%;特异性78%）;假阳性诊断部分是由于极早产儿难以区分出血与正常脉络丛。9名婴儿的出血性实质病变被正确识别（敏感性82%;特异性97%）。在39个有缺氧缺血性损伤组织学证据的半球中，只有11个半球被超声正确识别（灵敏度为28%），主要是因为未能检测到小面积的脑室周围白质软化和弥漫性神经胶质增生。10个脑室周围回声密度被认为代表白质软化的半球没有显示缺氧缺血性损伤的组织学证据（特异性86%）。尸检时，7名婴儿的心室扩张总是与缺氧缺血性损伤的证据相关。
Abnormalities detected by a mechanical sector scanner were compared ‘blind’ with autopsy findings in the brains of 56 infants born at less than 33 weeks gestation. Intraventricular haemorrhage was found in 53 of 112 hemispheres and had been accurately diagnosed by ultrasound (sensitivity 91 per cent; specificity 81 per cent). Isolated germinal layer haemorrhage was less successfully identified (sensitivity 61 per cent; specificity 78 per cent); false‐positive diagnoses were partly due to difficulty in distinguishing haemorrhage from the normal choroid plexus in extremely preterm infants. Haemorrhagic parenchymal lesions were correctly identified in nine infants (sensitivity 82 per cent; specificity 97 per cent). Only 11 of 39 hemispheres with histological evidence of hypoxic‐ischaemic injury, without marked bleeding, were correctly identified by ultrasound (sensitivity 28 per cent), mainly because of failure to detect small areas of periventricular leucomalacia and diffuse gliosis. 10 hemispheres with periventricular echodensities thought to represent leucomalacia showed no histological evidence of hypoxic‐ischaemic injury (specificity 86 per cent). Ventricular dilatation in seven infants was always associated with evidence of hypoxic‐ischaemic injury at autopsy.