Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2012 Aug;75(8):389-95. doi: 10.1016/j.jcma.2012.06.007. Epub 2012 Jul 25.
Ultrasonography is a non-invasive diagnostic technique, and it has been used to detect intracranial lesions in neonates for a long time. Correspondingly, screening tests using cranial ultrasonography have been applied for early detection of intracranial lesions in full-term neonates during the past decade.
We retrospectively reviewed the findings of cranial ultrasonographic screening tests in healthy full-term neonates between September 2004 and August 2009. The ultrasonographic findings were divided into the following categories: (a) nonsignificant (NS) group, including normal and normal variations, (b) minor anomaly group, including tiny cystic lesions, mild hemorrhage, or mild ventricular anomaly, and (c) major anomaly group, including significant anomaly of any intracranial pathology. The participants with major anomalies were further reviewed, and the following medical records of all enrolled patients were reviewed until they were 24 months of age.
There were a total of 3186 neonates who received cranial ultrasonographic screening examination during the 5-year period, and most of them (2982 cases, 93.6%) were assigned to the NS group. The most common normal variation was the presence of cavum septum pellucidum (1979 cases, 62.1%). Minor anomalies were found in 202 (6.3%) neonates, including 119 (3.7%) neonates with tiny cysts, and 59 (1.9%) neonates with mild intraventricular hemorrhage. Major anomalies were found in two (0.06%) neonates, including obstructive hydrocephalus and agenesis of the corpus callosum. Two other infants (0.06%) initially presented with minor anomaly or normal variation, but they were diagnosed as Moyamoya disease and neonatal seizure some months later.
The incidence of minor and major anomalies detected by cranial ultrasonographic screening examinations in healthy full-term neonates is 6.3% and 0.06%, respectively. Thus, cranial ultrasonographic screening testing may play a role in the early diagnosis of intracranial anomalies of otherwise healthy neonates. However, this examination cannot exclude or detect all cranial abnormalities, including many potential neurologic diseases of neonates, so continuing clinical diligence is still important for all infants.
超声检查是一种非侵入性诊断技术，长期以来一直用于检测新生儿颅内病变。相应地，过去十年中，针对足月新生儿应用了经颅超声筛查试验以早期发现颅内病变。
我们回顾性分析了 2004 年 9 月至 2009 年 8 月间健康足月新生儿经颅超声筛查的结果。将超声检查结果分为以下几类：（a）无明显异常（NS）组，包括正常和正常变异；（b）轻度异常组，包括微小囊性病变、轻度出血或轻度脑室异常；（c）严重异常组，包括任何颅内病变的显著异常。对存在严重异常的患儿进一步进行了评估，并对所有纳入患儿的病历进行了回顾，直至他们 24 月龄时。
5 年间共有 3186 例新生儿接受了经颅超声筛查检查，其中大多数（2982 例，93.6%）被归入 NS 组。最常见的正常变异是存在透明隔腔（1979 例，62.1%）。202 例（6.3%）新生儿发现轻度异常，包括 119 例（3.7%）新生儿有微小囊肿，59 例（1.9%）新生儿有轻度脑室出血。2 例（0.06%）新生儿发现严重异常，包括梗阻性脑积水和胼胝体发育不全。另有 2 例（0.06%）新生儿最初表现为轻度异常或正常变异，但数月后被诊断为烟雾病和新生儿癫痫。
健康足月新生儿经颅超声筛查发现的轻度和重度异常发生率分别为 6.3%和 0.06%。因此，经颅超声筛查可能有助于早期诊断无明显异常的新生儿颅内异常。但是，该检查不能排除或发现所有颅部异常，包括许多新生儿潜在的神经疾病，因此，所有婴儿仍需继续进行临床监测。
