Division of Pediatric Surgery, University of Utah, Primary Children's Medical Center, Salt Lake City, UT 84113, USA.
J Pediatr Surg. 2012 Jan;47(1):76-80. doi: 10.1016/j.jpedsurg.2011.10.016.
The need for routine neuroimaging after extracorporeal membrane oxygenation (ECMO) and the optimal radiographic study remains unclear. We sought to evaluate the correlation between findings on head ultrasound (HUS) and magnetic resonance imaging (MRI) and determine the association of these findings to neurodevelopmental outcome.
A retrospective review was performed (2003-2010) to identify neonates who had a MRI after ECMO. Each MRI was reviewed by a single pediatric neuroradiologist. Neurodevelopmental data was collected from the high-risk neonatal follow-up clinic.
Fifty neonates had a MRI (venoarterial 37, venovenous 13) after ECMO. HUS was abnormal in 24%, whereas MRI was abnormal in 62%. All infants with an abnormal HUS had an abnormal MRI, but an additional 50% of patients with a normal HUS had an abnormal MRI. Venoarterial ECMO was significantly associated with an abnormal MRI. Follow-up data was available for 26 neonates. The only predictor of abnormal neurodevelopment was the need for supplemental tube feeds at discharge.
MRI identified significantly more abnormalities compared to routine HUS after neonatal ECMO. However, neither MRI nor HUS findings correlated with early neurodevelopmental outcome. Feeding ability at discharge was the overall best predictor of neurologic impairment in survivors.
体外膜肺氧合（ECMO）后常规神经影像学检查的必要性和最佳影像学研究仍不清楚。我们旨在评估头颅超声（HUS）和磁共振成像（MRI）检查结果之间的相关性，并确定这些检查结果与神经发育结局的关系。
进行了一项回顾性研究（2003-2010 年），以确定 ECMO 后进行 MRI 的新生儿。每例 MRI 均由一名儿科神经放射科医生进行评估。神经发育数据来自高危新生儿随访诊所。
50 例新生儿在 ECMO 后进行了 MRI（动静脉 37 例，静脉-静脉 13 例）。HUS 异常者占 24%，MRI 异常者占 62%。所有 HUS 异常的婴儿均有 MRI 异常，但 50%的 HUS 正常婴儿也有 MRI 异常。动静脉 ECMO 与 MRI 异常显著相关。26 例新生儿可获得随访数据。唯一预测神经发育异常的指标是出院时需要补充管饲。
与新生儿 ECMO 后常规 HUS 相比，MRI 可发现更多异常。然而，MRI 和 HUS 检查结果均与早期神经发育结局无关。出院时的喂养能力是幸存者神经功能障碍的总体最佳预测指标。
