Földi Tamara, Kiss Judit, Gajda Anna, Pásztor Gyula, Bereczki Csaba, Mari Judit
1 Dr. Frank Schumann Nőgyógyászati Szakorvosi Rendelőintézet Wertheim Németország.
2 Szegedi Tudományegyetem, Szent-Györgyi Albert Orvostudományi Kar, Gyermekgyógyászati Klinika és Gyermekegészségügyi Központ Szeged, Korányi fasor 14-15., 6720 Magyarország.
Orv Hetil. 2023 Aug 6;164(31):1222-1230. doi: 10.1556/650.2023.32818.
Previously, all admitted neonates to our tertiary Neonatal Unit, University of Szeged, had a cranial and abdominal ultrasound performed as part of their care.
To analyze the findings and to evaluate the effectiveness of the universal ultrasound screening.
Results of cranial and abdominal ultrasound imaging performed in our Unit between 1st January 2014 and 31st December 2015 were analyzed retrospectively. Abnormalities found during the screening scans were studied further and assessed until discharge and during the first 2 years. All imagings were performed by a radiologist.
During the examined 2 years, 579 neonates were admitted (gestational age mean 34.2 weeks [23-41, SD ± 4.04]), abdominal ultrasound was performed in 562 (97%) and cranial ultrasound in 560 (97%) babies, on the 3.6th day of life at an average (0-18, SD ± 2.24). Of all abdominal ultrasound scans, 87% (n = 488) was carried out as screening, and the found abnormalities in 140 (29%) of the cases: renal pelvic dilatation (n = 67 [47.9%]), free abdominal fluid (n = 17 [12.1%]), echogenic kidneys (n = 13 [9.3%]), congenital abnormalities of the kidney and urinary tract (n = 9 [6.4%]), abnormalities of the liver, bile system, adrenal gland [n = 14 [10%]). The screening identified 4 (0.8%) neonates with renal abnormilaties requiring surgical correction. In regards of renal abnormalities, we observed male (p = 0.18) and left sided (p = 0.54) predominance. Screening cranial ultrasound was performed in 65% (n = 362) of all neonates, discovering 51 (14%) anomalies: plexus chorioideus cyst (n = 21 [41%]), plexus chorioideus hemorrhage (n = 9 [17.6%]), mild ventricular asymmetry (n = 8 [15.7%]), subependymal hemorrhage (n = 5 [9.8%]), abnormalities of the periventricular area (n = 4 [7.8%]), colpocephaly, hydrocephalus externus, echogenic meninx and thalamic nodule [n = 1-1 (1.9-1.9%)].
Abdominal ultrasound screening discovered renal abnormalities and umbilical line complications as clinically relevant findings. However, a small number of renal abnormalities identified by screening required surgical intervention. Further studies are needed to identify possible risk groups to develop more efficient screening strategy to decrease the number of screened babies for 1 relevant finding (number to screen). Cranial ultrasound screening did not identify any abnormalities that needed intervention. We can not recommend universal cranial ultrasound screening based on our results. Orv Hetil. 2023; 164(31): 1222-1230.
此前，我们塞格德大学三级新生儿病房收治的所有新生儿在护理过程中均接受了头颅和腹部超声检查。
分析检查结果并评估通用超声筛查的有效性。
回顾性分析2014年1月1日至2015年12月31日期间在我们病房进行的头颅和腹部超声成像结果。对筛查扫描中发现的异常进行进一步研究，并在出院前及头两年进行评估。所有成像均由放射科医生进行。
在检查的2年期间，共收治579例新生儿（平均胎龄34.2周[23 - 41周，标准差±4.04]），562例（97%）婴儿进行了腹部超声检查，560例（97%）婴儿进行了头颅超声检查，平均在出生后3.6天（0 - 18天，标准差±2.24）进行。在所有腹部超声扫描中，87%（n = 488）为筛查，140例（29%）病例发现异常：肾盂扩张（n = 67 [47.9%]）、腹腔游离液体（n = 17 [12.1%]）、肾回声增强（n = 13 [9.3%]）、先天性肾和泌尿系统异常（n = 9 [6.4%]）、肝脏、胆道系统、肾上腺异常[n = 14 [10%]）。筛查发现4例（0.8%）有需要手术矫正的肾脏异常新生儿。关于肾脏异常，我们观察到男性（p = 0.18）和左侧（p = 0.54）占优势。所有新生儿中65%（n = 362）进行了筛查头颅超声检查，发现51例（14%）异常：脉络丛囊肿（n = 21 [41%]）、脉络丛出血（n = 9 [17.6%]）、轻度脑室不对称（n = 8 [15.7%]）、室管膜下出血（n = 5 [9.8%]）、脑室周围区域异常（n = 4 [7.8%]）、小脑畸形、外部脑积水、脑膜回声增强和丘脑结节[n = 1 - 1例（1.9 - 1.9%）]。
腹部超声筛查发现肾脏异常和脐线并发症为临床相关发现。然而，筛查发现的少数肾脏异常需要手术干预。需要进一步研究以确定可能的风险组，制定更有效的筛查策略，以减少为1个相关发现进行筛查的婴儿数量（筛查数量）。头颅超声筛查未发现任何需要干预的异常。基于我们的结果，我们不建议进行通用的头颅超声筛查。《匈牙利医学周报》。2023年；164(31): 1222 - 1230。
