Shin Hyun Joo, Kim Myung-Joon, Lee Hye Sun, Namgung Ran, Park Kook In, Lee Mi-Jung
Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Yonsei University, College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea.
Biostatistics Collaboration Unit, Yonsei University, College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea.
J Clin Ultrasound. 2015 Jul-Aug;43(6):367-74. doi: 10.1002/jcu.22196. Epub 2014 Jun 27.
To evaluate the relationship between the imaging patterns of lenticulostriate vasculopathy (LSV) and clinical outcomes.
We performed cranial sonography (US) in 110 neonates and evaluated the patterns of visible lenticulostriate vessels with three grades: 0: no vessel seen; 1 (low grade): one or two thin branches seen; and 2 (high grade): more than three prominent branches seen. Color Doppler US was performed on these vessels to evaluate the presence of flow. Associated underlying diseases and the presence of neurodevelopmental delay on follow-up were reviewed retrospectively.
There were 51 neonates with associated underlying diseases, including congenital heart diseases (CHD) (n = 34) and neonatal hypoxia (n = 13). Sonographic LSV was detected in 29.1% cases (22 low- and 10 high-grade cases). Doppler flow was not detected in three patients with CHD (p = 0.028). CHD (odds ratio [OR], 25.73; p < 0.001), neonatal hypoxia (OR, 7.00; p = 0.020), two underlying diseases (OR, 73.232; p < 0.001), high-grade LSV (OR, 16.29; p = 0.005), and absent color Doppler flow (OR, 40.80; p = 0.046) were significantly associated with neurodevelopmental delay in univariate analysis. In multivariate analysis, underlying diseases and absent color Doppler flow were associated with neurodevelopmental delay. Both high LSV grade (area under the receiver operating characteristic curves of 0.901; 95% confidence interval, 0.823-0.979) and absent color Doppler flow (area under the receiver operating characteristic curves of 0.874; 95% confidence interval, 0.803-0.945) had a high predictive power for neurodevelopmental delay.
High-grade sonographic LSV and absent color Doppler flow on lenticulostriate vessels were significantly associated with neurodevelopmental delay.
评估豆纹状血管病（LSV）的影像学表现与临床结局之间的关系。
我们对110例新生儿进行了头颅超声检查（US），并将可见的豆纹状血管的表现分为三个等级进行评估：0级：未见血管；1级（低级别）：可见一或两条细分支；2级（高级别）：可见三条以上明显分支。对这些血管进行彩色多普勒超声检查以评估血流情况。回顾性分析相关的基础疾病以及随访时神经发育迟缓的情况。
有51例新生儿患有相关基础疾病，包括先天性心脏病（CHD）（n = 34）和新生儿缺氧（n = 13）。超声检查发现29.1%的病例存在LSV（22例低级别和10例高级别病例）。3例CHD患者未检测到多普勒血流（p = 0.028）。单因素分析显示，CHD（比值比[OR]，25.73；p < 0.001）、新生儿缺氧（OR，7.00；p = 0.020）、两种基础疾病（OR，73.232；p < 0.001）、高级别LSV（OR，16.29；p = 0.005）以及彩色多普勒血流缺失（OR，40.80；p = 0.046）与神经发育迟缓显著相关。多因素分析显示，基础疾病和彩色多普勒血流缺失与神经发育迟缓相关。高级别LSV（受试者工作特征曲线下面积为0.901；95%置信区间，0.823 - 0.979）和彩色多普勒血流缺失（受试者工作特征曲线下面积为0.874；95%置信区间，0.803 - 0.945）对神经发育迟缓均具有较高的预测能力。
高级别超声LSV以及豆纹状血管彩色多普勒血流缺失与神经发育迟缓显著相关。
