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目的通过头颅MRI与B超在早产儿脑损伤诊断中的对比研究,探讨头颅MRI、B超对早产儿脑损伤的诊断价值。方法对2010年l月至2011年12月期间,南方医院新生儿科收治的152例早产儿,住院期间行头颅MRI、B超检查,用配对χ2检验比较两种检查方法有无差异,比较各自诊断的准确性与敏感性。结果头颅MRI、B超对早产儿脑损伤的诊断存在显著差异(χ2=27.119,P<0.001),MRI与B超诊断的准确性分别为94.1%、67.1%,敏感性分别为90.0%、44.4%,对IVH诊断一致率为85.16%,新生儿缺氧缺血性脑(HIE)诊断一致率47.83%,脑白质软化(PVL)诊断一致率为33.3%,B超未能发现蛛网膜下腔出血(SAH)、硬膜下出血(SDH)、小脑出血(ICEH)。结论头颅B超显示IVH强于MRI,但B超对HIE、PVL的诊断逊于MRI,B超容易漏诊合并有SAH、SDH、ICEH的脑损伤,B超只可作为初诊、随访追踪的方法。
Objective To compare the diagnostic value of cranial MRI and B-ultrasound in the diagnosis of brain injury in premature infants and explore the diagnostic value of cranial MRI and B-ultrasound in premature infants with brain injury. Methods From January 2010 to December 2011, 152 preterm infants admitted to the neonatology department of Nanfang Hospital underwent head MRI and B-ultrasound during the hospital stay. The differences between the two methods were compared by pairedχ2 test. Accuracy and sensitivity. Results The diagnostic accuracy of cranial MRI and B ultrasound in preterm infants with brain injury was significantly different (χ2 = 27.119, P <0.001). The diagnostic accuracy of MRI and B ultrasonography was 94.1% and 67.1%, respectively, and the sensitivities were 90.0% and 44.4 %, The consistency rate of diagnosis of IVH was 85.16%, the diagnostic consistency rate of neonatal hypoxic-ischemic brain (HIE) was 47.83%, the diagnostic coincidence rate of white matter (PVL) was 33.3%, B-ultrasound failed to find subarachnoid space Bleeding (SAH), Subdural Hemorrhage (SDH), Cerebral Hemorrhage (ICEH). Conclusion The B-mode ultrasound shows that the IVH is better than MRI. However, the diagnosis of HIE and PVL by B-mode ultrasound is inferior to that of MRI. The B-mode ultrasonography is easy to miss the brain injury with SAH, SDH and ICEH. B-mode ultrasound can be used as the first visit and follow-up method.