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足月儿全头部超声筛查:6771例婴儿的回顾性分析

Universal Head Ultrasound Screening in Full-term Neonates: A Retrospective Analysis of 6771 Infants.

作者信息

Ballardini Elisa, Tarocco Anna, Rosignoli Chiara, Baldan Alessandro, Borgna-Pignatti Caterina, Garani Giampaolo

机构信息

Pediatric Unit, Department of Medical Sciences, University Hospital of Ferrara, Ferrara, Italy.

Pediatric Unit, Department of Medical Sciences, University Hospital of Ferrara, Ferrara, Italy.

出版信息

Pediatr Neurol. 2017 Jun;71:14-17. doi: 10.1016/j.pediatrneurol.2017.03.012. Epub 2017 Mar 30.

Abstract

BACKGROUND

Full-term neonates may have asymptomatic cranial injuries at birth and head ultrasound screening could be useful for early diagnosis. The aim of this study was to assess the prevalence and type of intracranial abnormalities and the usefulness of head ultrasound screening in these infants.

METHODS

Head ultrasound screening was performed on all full-term neonates (gestational age between 37 and 42 weeks), born at Sant'Anna University Hospital of Ferrara, Italy, from June 1, 2008 through May 31, 2013. Ultrasound findings were categorized into three groups: normal, minor, and major anomalies.

RESULTS

All full-term neonates (6771) born at our hospital underwent head ultrasound screening. One hundred fourteen of 6771 (1.7%) presented ultrasound abnormalities, whereas 6657 were normal or exhibited insignificant findings. In 101 of 114 (88.6%), abnormalities were minor, and only 13 infants had major abnormalities (0.19% of all full-term newborns). All neonates with major abnormalities presented with either microcephaly or abnormal neurological evaluations. Only one individual with major abnormalities was detected exclusively by ultrasound.

CONCLUSIONS

The number of significant anomalies detected by head ultrasound screening in asymptomatic full-term neonates born during the study period was low. Therefore, there is no indication for routine general head ultrasound screening in these patients. However, even if low, in neonates who have neurological abnormalities, risk factors or suspected brain malformations, head ultrasound screening may play an important role in the early diagnosis of intracranial anomalies.

摘要

背景

足月儿出生时可能有无症状颅脑损伤,而头部超声筛查有助于早期诊断。本研究旨在评估这些婴儿颅内异常的患病率和类型以及头部超声筛查的效用。

方法

对2008年6月1日至2013年5月31日在意大利费拉拉圣安娜大学医院出生的所有足月儿(胎龄37至42周)进行头部超声筛查。超声检查结果分为三组:正常、轻度异常和重度异常。

结果

我院出生的所有足月儿(6771例)均接受了头部超声筛查。6771例中有114例(1.7%)出现超声异常,而6657例正常或表现为无明显意义的结果。114例中有101例(88.6%)异常为轻度,只有13例婴儿有重度异常(占所有足月儿的0.19%)。所有有重度异常的新生儿均表现为小头畸形或神经评估异常。仅1例有重度异常的患儿是通过超声单独检测出的。

结论

在研究期间出生的无症状足月儿中,通过头部超声筛查检测到的显著异常数量较少。因此,这些患者没有常规进行一般头部超声筛查的指征。然而,即使数量较少,对于有神经异常、危险因素或疑似脑畸形的新生儿,头部超声筛查可能在颅内异常的早期诊断中发挥重要作用。

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