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目的探讨早产儿缺氧缺血性脑病(HIE)CT的影像学特征及其诊断价值。方法对55例临床诊断缺氧缺血性脑病早产儿进行头颅CT检查,分析其影像特征,初次检查时间生后7d内,CT复查时间纠正胎龄为40周。结果 55例患儿脑实质内均可见低密度影,胎龄越小,窒息越重,低密度范围越广泛。CT分度轻度者26例,占47.3%,合并脑室管膜下出血14例,脑室内出血5例,蛛网膜下腔出血7例;CT分度中度者16例,占29.1%,合并室管膜下出血4例,脑室内出血7例,蛛网膜下腔出血5例;CT分度重度者13例,占23.6%,合并蛛网膜下腔出血3例,脑室出血5例。结论早产儿HIE病灶低密度范围越广泛,发生后遗症概率越高,程度越重;轻度HIE早产儿合并症少预后较好,中度HIE需结合CT病灶密度及合并症情况来判定预后;重度HIE常合并多类型、多部位出血,预后较差。
Objective To investigate the imaging features and diagnostic value of hypoxic-ischemic encephalopathy (HIE) in preterm infants. Methods Fifty-five preterm infants with hypoxic-ischemic encephalopathy (HIE) underwent head CT examination. The imaging features were analyzed. Within 7 days after the initial examination, the CT examination was performed to correct the gestational age at 40 weeks. Results 55 cases of children with intraparenchymal low density can be seen, the smaller the gestational age, the heavier the suffocation, the more extensive low density range. 26 cases were mildly classified by CT, accounting for 47.3%. There were 14 cases with subependymal hemorrhage, 5 cases with intracerebral hemorrhage and 7 cases with subarachnoid hemorrhage. CT was moderately diagnosed in 16 cases (29.1%), combined room 4 cases of subdural hemorrhage, 7 cases of intracerebral hemorrhage and 5 cases of subarachnoid hemorrhage. Thirteen patients (23.6%) had severe degree of CT, 3 cases had subarachnoid hemorrhage and 5 cases had ventricular hemorrhage. Conclusion HIE lesions in preterm infants with a wider range of low density, the higher the probability of sequelae, the more severe; mild HIE premature children with less favorable prognosis, moderate HIE need to be combined with CT lesions and complications to determine the prognosis; severe HIE often combined with multiple types, multiple parts of bleeding, the prognosis is poor.