新生儿颅内缺血与出血：超声、CT及磁共振成像诊断
Neonatal intracranial ischemia and hemorrhage: diagnosis with US, CT, and MR imaging.
作者信息
Blankenberg F G, Norbash A M, Lane B, Stevenson D K, Bracci P M, Enzmann D R
机构信息
Department of Radiology, Stanford University Hospital, Calif, USA.
出版信息
Radiology. 1996 Apr;199(1):253-9. doi: 10.1148/radiology.199.1.8633155.
PURPOSE
To assess the usefulness of ultrasound (US), computed tomography (CT), and magnetic resonance (MR) imaging in the detection of intracranial hemorrhage and ischemia in newborns.
MATERIALS AND METHODS
Seventy-six neonates who underwent US within 72 hours of CT or MR examination were studied. Four observers rated images for the presence of germinal matrix hemorrhage (GMH), intraventricular hemorrhage (IPH), extraaxial hemorrhage, and hypoxic-ischemic encephalopathy.
RESULTS
In 39% of neonates, CT and MR imaging provided greater confidence than US for the diagnosis or exlusion of neonatal ischemia or hemorrhage. Kappa analysis revealed significantly better interobserver agreement with CT than with US for the detection of GMH, IVH, IPH, and cortical infarction or ischemia (P <.005). Interobserver agreement was significantly better with MR imaging than with US for the detection of GMH, IVH, and cortical infarction or ischemia (P < .005).
CONCLUSION
Sensitivity and interobserver agreement are better with MR imaging and CT than with US for the detection of neonatal cortical ischemia or infarction.
目的
评估超声（US）、计算机断层扫描（CT）和磁共振成像（MR）在检测新生儿颅内出血和缺血方面的实用性。
材料与方法
对76例在CT或MR检查后72小时内接受超声检查的新生儿进行研究。4名观察者对图像进行评估，判断是否存在生发基质出血（GMH）、脑室内出血（IPH）、轴外出血和缺氧缺血性脑病。
结果
在39%的新生儿中，CT和MR成像在诊断或排除新生儿缺血或出血方面比超声更具可信度。Kappa分析显示，在检测GMH、IVH、IPH以及皮质梗死或缺血方面，观察者间对CT的一致性显著优于超声（P <.005）。在检测GMH、IVH和皮质梗死或缺血方面，观察者间对MR成像的一致性显著优于超声（P <.005）。
结论
在检测新生儿皮质缺血或梗死方面，MR成像和CT的敏感性及观察者间一致性优于超声。
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