Haataja L, Mercuri E, Cowan F, Dubowitz L
Department of Paediatrics and Neonatal Medicine, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK.
Arch Dis Child Fetal Neonatal Ed. 2000 Mar;82(2):F128-33. doi: 10.1136/fn.82.2.f128.
To investigate whether cranial ultrasound abnormalities found in low risk full term infants had any influence on neurodevelopmental outcome.
For 103 infants who had a neurological assessment, a cranial ultrasound examination, and for whom antenatal and perinatal data were collected within 48 hours of delivery, neurodevelopmental status was evaluated at 12 and 18 months. The results of a scored neurological examination and the Griffiths mental developmental scale were correlated with the presence and type of ultrasound abnormality found in the neonatal period.
None of the infants with ultrasound abnormalities showed any signs of cerebral palsy or severe developmental delay. There was also no significant difference between the overall neurological and neurodevelopmental scores of the infants with normal and abnormal ultrasound findings. However, when the individual subscales of the Griffiths test were analysed, all infants with bulky choroid or intraventricular haemorrhage had normal scores in all subscales, four of eight with periventricular white matter lesions had low scores on the locomotor subscale, and three of five with asymmetrical ventricles had low scores on the performance subscale. The presence of adverse antenatal and perinatal factors did not affect the outcome in this group.
Incidental ultrasound abnormality in full term neonates, in particular intraventricular haemorrhage, although common, appear to have a good prognosis. Longer follow up studies are needed to see whether some of these infants, in particular those with white matter lesions, develop dyspraxia or other minor neurological impairments at school age.
探讨低风险足月儿中发现的颅脑超声异常是否对神经发育结局有任何影响。
对103例接受了神经评估、颅脑超声检查且在分娩后48小时内收集了产前和围产期数据的婴儿，在12个月和18个月时评估其神经发育状况。将评分后的神经检查结果和格里菲斯心理发育量表结果与新生儿期发现的超声异常的存在情况及类型进行关联分析。
超声异常的婴儿均未表现出任何脑瘫或严重发育迟缓的迹象。超声检查结果正常和异常的婴儿在总体神经和神经发育评分上也没有显著差异。然而，在分析格里菲斯测试的各个子量表时，所有脉络丛粗大或脑室内出血的婴儿在所有子量表上的得分均正常，8例脑室周围白质病变婴儿中有4例在运动子量表上得分较低，5例脑室不对称婴儿中有3例在操作子量表上得分较低。产前和围产期不良因素的存在并未影响该组的结局。
足月儿偶然出现的超声异常，尤其是脑室内出血，虽然常见，但似乎预后良好。需要进行更长时间的随访研究，以观察这些婴儿中的一些，特别是有白质病变的婴儿，在学龄期是否会出现运动障碍或其他轻微神经损伤。
