中国医学影像学杂志
中國醫學影像學雜誌
중국의학영상학잡지
CHINESE JOURNAL OF MEDICAL IMAGING
2013年
10期
749-751,753
,共4页
脑出血%脑室%超声检查,多普勒,彩色%婴儿,早产
腦齣血%腦室%超聲檢查,多普勒,綵色%嬰兒,早產
뇌출혈%뇌실%초성검사,다보륵,채색%영인,조산
Cerebral hemorrhage%Cerebral ventricles%Ultrasonography,Doppler,color%Infant,premature
目的：观察早产儿脑室周围-脑室内出血（PIVH）的超声表现，评价颅脑超声早期诊断PIVH的价值。资料与方法555例早产儿进行床边颅脑超声检查，回顾性分析其超声图像特征，并进行Papile分级，以Ⅲ、Ⅳ级PIVH为重度出血。结果超声检出PIVH 125例（22.52%），其中PapileⅠ级111例（88.8%），表现为侧脑室前角后下方、丘脑尾状核沟处强回声团；PapileⅡ级7例（5.6%），表现为侧脑室三角区及后角内脉络膜丛回声增强、形态不规则增宽或孤立团块影；PapileⅢ级7例（5.6%），表现为侧脑室内强回声团伴脑室扩张。重度PIVH 7例（1.26%）。胎龄<32周、≥32周早产儿PIVH总发病率分别为45.05%、16.89%；出生体重<1500 g、≥1500 g早产儿PIVH总发病率分别为44.16%、19.04%，胎龄<32周、出生体重<1500 g的早产儿PIVH总发病率明显高于胎龄≥32周、出生体重≥1500 g的早产儿，差异均有统计学意义（χ2=40.334、23.978, P<0.01）。结论早产儿胎龄越小、出生体重越低，PIVH发生率越高。对早产儿进行常规颅脑超声检查能早期诊断PIVH并能进行Papile分级，以早期指导临床干预治疗。
目的：觀察早產兒腦室週圍-腦室內齣血（PIVH）的超聲錶現，評價顱腦超聲早期診斷PIVH的價值。資料與方法555例早產兒進行床邊顱腦超聲檢查，迴顧性分析其超聲圖像特徵，併進行Papile分級，以Ⅲ、Ⅳ級PIVH為重度齣血。結果超聲檢齣PIVH 125例（22.52%），其中PapileⅠ級111例（88.8%），錶現為側腦室前角後下方、丘腦尾狀覈溝處彊迴聲糰；PapileⅡ級7例（5.6%），錶現為側腦室三角區及後角內脈絡膜叢迴聲增彊、形態不規則增寬或孤立糰塊影；PapileⅢ級7例（5.6%），錶現為側腦室內彊迴聲糰伴腦室擴張。重度PIVH 7例（1.26%）。胎齡<32週、≥32週早產兒PIVH總髮病率分彆為45.05%、16.89%；齣生體重<1500 g、≥1500 g早產兒PIVH總髮病率分彆為44.16%、19.04%，胎齡<32週、齣生體重<1500 g的早產兒PIVH總髮病率明顯高于胎齡≥32週、齣生體重≥1500 g的早產兒，差異均有統計學意義（χ2=40.334、23.978, P<0.01）。結論早產兒胎齡越小、齣生體重越低，PIVH髮生率越高。對早產兒進行常規顱腦超聲檢查能早期診斷PIVH併能進行Papile分級，以早期指導臨床榦預治療。
목적：관찰조산인뇌실주위-뇌실내출혈（PIVH）적초성표현，평개로뇌초성조기진단PIVH적개치。자료여방법555례조산인진행상변로뇌초성검사，회고성분석기초성도상특정，병진행Papile분급，이Ⅲ、Ⅳ급PIVH위중도출혈。결과초성검출PIVH 125례（22.52%），기중PapileⅠ급111례（88.8%），표현위측뇌실전각후하방、구뇌미상핵구처강회성단；PapileⅡ급7례（5.6%），표현위측뇌실삼각구급후각내맥락막총회성증강、형태불규칙증관혹고립단괴영；PapileⅢ급7례（5.6%），표현위측뇌실내강회성단반뇌실확장。중도PIVH 7례（1.26%）。태령<32주、≥32주조산인PIVH총발병솔분별위45.05%、16.89%；출생체중<1500 g、≥1500 g조산인PIVH총발병솔분별위44.16%、19.04%，태령<32주、출생체중<1500 g적조산인PIVH총발병솔명현고우태령≥32주、출생체중≥1500 g적조산인，차이균유통계학의의（χ2=40.334、23.978, P<0.01）。결론조산인태령월소、출생체중월저，PIVH발생솔월고。대조산인진행상규로뇌초성검사능조기진단PIVH병능진행Papile분급，이조기지도림상간예치료。
Purpose To observe the ultrasonographic features of periventricular-intraventricular hemorrhage (PIVH) in preterm infants, to evaluate the value of cranial ultrasound for early diagnosis of PIVH. Materials and Methods 555 cases of premature children underwent bedside cranial ultrasound examination, characteristics of their ultrasound images were retrospectively analyzed and categorized with Papile grading, gradeⅢandⅣPIVH were defined as severe bleeding. Results 125 PIVH cases (22.52%) were detected by ultrasound, of which 111 cases (88.8%) were Papile gradeⅠ, manifested as hyperechoic group localized in the rear and below lateral ventricle anterior horn and in the sulcus of hypothalamic caudate nucleuscaudate;7 cases (5.6%) were Papile gradeⅡ, manifested as increased echogenicity, irregular widen or isolated mass shadow of the choroid plexus within the triangle zone and posterior horn of the lateral ventricle;7 cases (5.6%) were Papile gradeⅢ, manifested as hyperechoic group within the lateral ventricle with ventricular dilatation. 7 cases (1.26%) were severe PIVH. Overall incidence rates of PIVH in premature children whose gestational age was <32 weeks and ≥ 32 weeks were 45.05% and 16.89% respectively; overall incidence rates of PIVH for preterm infants whose birth weight were <1500 g and ≥ 1500 g were 44.16% and 19.04%, overall incidence of PIVH of preterm infants with gestational age<32 weeks and birth weight<1500 g was significantly higher than their contemporaries with gestational age≥32 weeks and birth weight ≥1500 g, and the differences were statistically significant (χ2=40.334, 23.978; P<0.01). Conclusion Incidence of PIVH becomes higher when the gestational age of preterm child is smaller and the birth weight is lower. Performing routine cranial ultrasound examination for preterm infants is important for early diagnosis of PIVH and Papile grading, thus will instruct the clinical intervention in early stage.
