Department of ultrasound medicine, Guangzhou women and children medical center, Guangzhou medical university, 9, Jinsui road, 510120 Guangzhou, China.
Department of ultrasound medicine, Guangzhou women and children medical center, Guangzhou medical university, 9, Jinsui road, 510120 Guangzhou, China.
Diagn Interv Imaging. 2017 Jun;98(6):469-475. doi: 10.1016/j.diii.2016.12.001. Epub 2016 Dec 23.
To describe the ultrasound presentation of the brain and cerebral hemodynamics in neonates with hypoxic-ischemic encephalopathy (HIE) by comparison with control subjects.
During June 2012 to April 2013, full term neonates who had clinical evidence of HIE were enrolled. Healthy newborns without HIE were used as a control group. Cerebral parenchyma, size of lateral ventricles and hemodynamic parameters of cerebral arteries were studied using two-dimensional duplex and color Doppler ultrasound. Neonates with moderate and severe HIE were followed-up with ultrasound for at least 3 months.
A total of 158 consecutive neonates (82 boys and 76 girls), including 54 with mild HIE, 60 with moderate HIE and 44 with severe HIE were included. One hundred and twenty healthy newborns were randomly selected as a control group. Abnormal ultrasound findings of brain parenchyma were found in 25/54 (46.3%) neonates with mild HIE whereas they were found in 58/60 (96.7%) neonates with moderate HIE and 44/44 (100%) neonates with severe HIE. Almost all neonates with severe HIE had decreased cerebral artery blood flow velocity and increased resistance index of cerebral arteries. Of the 104 neonates with moderate or severe HIE, follow-up ultrasound examination revealed cystic parenchymal lesions in 12/104 (11.5%), progressive ventricular dilatation and brain atrophy in 12/104 (11.5%), mild ventricular dilatation in 15/104 (14.4%) and leukoencephalomalacia in 2/104 (1.9%) neonates.
Ultrasound features such as the size of lateral ventricles, altered brain parenchymal echogenicity and cerebral blood flow parameters are useful for the early diagnosis of HIE and help predict outcome.
通过与对照组比较，描述缺氧缺血性脑病（HIE）新生儿的脑超声表现和脑血流动力学。
2012 年 6 月至 2013 年 4 月期间，我们纳入了有临床 HIE 证据的足月新生儿。无 HIE 的健康新生儿作为对照组。使用二维双功及彩色多普勒超声研究脑实质、侧脑室大小和脑动脉血流动力学参数。中重度 HIE 新生儿至少进行 3 个月的超声随访。
共纳入 158 例连续新生儿（82 例男婴，76 例女婴），其中轻度 HIE 54 例，中度 HIE 60 例，重度 HIE 44 例。随机选择 120 例健康新生儿作为对照组。轻度 HIE 中 25/54（46.3%）例新生儿脑实质超声检查异常，中度 HIE 中 58/60（96.7%）例和重度 HIE 中 44/44（100%）例异常。几乎所有重度 HIE 新生儿均有脑动脉血流速度降低和阻力指数增高。在 104 例中重度 HIE 新生儿中，12/104（11.5%）例有囊性脑实质病变，12/104（11.5%）例进行性脑室扩大和脑萎缩，15/104（14.4%）例轻度脑室扩大，2/104（1.9%）例白质软化。
侧脑室大小、脑实质回声改变和脑血流参数等超声特征有助于 HIE 的早期诊断，并有助于预测预后。
