Rennie J M, Coughtrey H, Morley R, Evans D H
NICU, Rosie Maternity Hospital, Cambridge, UK.
J Clin Ultrasound. 1995 Jan;23(1):27-31. doi: 10.1002/jcu.1870230106.
Seventy-four low birth weight infants underwent serial measurements of cerebral blood flow velocity (CBFV) using Doppler ultrasound together with ultrasound imaging of the brain. Surviving infants were examined and assessed using the Bayley scales of mental and motor development at 18 months post-term. There were no significant differences in mean CBFV between normal and impaired infants. Infants with abnormal neurological signs (n = 6) or developmental delay (n = 3) did not show the usual steady rise in CBFV during the first few days of life. Four of nine had a rise, then a fall in CBFV compared with 4 of 31 with complete data in the normal group. This difference is significant (chi 2 = 4.3, p = 0.03). The magnitude of the percentage increase between day 1 and day 3 was also smaller in the abnormal group (median 0% vs. 39%, Mann-Whitney p = 0.03). A structural abnormality seen on the cranial ultrasound image was a better predictor of adverse outcome than an abnormal CBFV pattern, with a better sensitivity and specificity (66% and 97% for imaging compared to 44% and 87% for CBFV). The addition of serial ultrasound Doppler measurements of CBFV did not improve the prediction of outcome obtained using ultrasound imaging alone.
74名低体重婴儿使用多普勒超声对脑血流速度（CBFV）进行了系列测量，并同时进行了脑部超声成像检查。存活的婴儿在足月后18个月时使用贝利智力和运动发育量表进行了检查和评估。正常婴儿和发育受损婴儿之间的平均CBFV没有显著差异。有异常神经体征的婴儿（n = 6）或发育迟缓的婴儿（n = 3）在出生后的头几天内，CBFV并未呈现出通常的稳定上升趋势。9名此类婴儿中有4名CBFV先上升后下降，而正常组31名有完整数据的婴儿中这一比例为4/31。这种差异具有统计学意义（卡方= 4.3，p = 0.03）。异常组第1天到第3天的百分比增加值也较小（中位数0%对39%，曼-惠特尼检验p = 0.03）。头颅超声图像上显示的结构异常比异常的CBFV模式更能预测不良结局，其敏感性和特异性更高（成像分别为66%和97%，而CBFV分别为44%和87%）。增加CBFV的系列超声多普勒测量并不能改善仅使用超声成像所获得的结局预测。
