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目的分析新生儿颅内出血的CT表现特点。方法选择2014年2月—2015年6月本院收治的颅内出血新生儿25例,均行头颅CT平扫。结果蛛网膜下腔出血13例,CT显示大脑纵裂池、外侧裂池、脑基底池内见高密度影,CT值为60~70 Hu,少量蛛网膜下腔出血表现前纵裂池,后纵裂池窄带、条状高密度影,中大量蛛网膜下腔出血表现纵裂池、外侧裂池、基底池呈脑池高密度铸型。脑实质出血7例,CT显示幕上脑实质及脑室周围多灶性点状、条状及片状高密度影,本组患儿中2例伴有脑室积血及蛛网膜下腔出血。硬膜下出血3例,CT表现紧贴颅骨内板下新月形高密度影,形态不规整,本组患儿3例均为胎头吸引助产引起。室管膜下及脑室内出血2例,CT表现尾状核附近局限高密度小出血灶和不同程度的脑室内出血,少量出血见侧脑室后角高密度影,其上方与脑脊液形成液平面;大量出血表现一侧或双侧脑室高密度脑室铸型。硬膜外出血本组患儿未发现,CT表现颅骨内板下双凸镜状或梭形高密度影,CT值50~90 Hu,边界清楚,范围局限,血肿一般不跨越颅缝。结论新生儿颅内出血主要包括蛛网膜下腔出血、脑实质出血、脑室积血蛛网膜下腔出血、硬膜下出血等,CT检查可根据其不同表现特点进行诊断。
Objective To analyze CT features of neonatal intracranial hemorrhage. Methods Twenty-five neonates with intracranial hemorrhage admitted from February 2014 to June 2015 in our hospital were examined with skull CT scan. Results 13 cases of subarachnoid hemorrhage, CT showed the longitudinal fissure pool, lateral fissure, brain base pool see the high density, CT value of 60 ~ 70 Hu, a small amount of subarachnoid hemorrhage in the former longitudinal fissure pool, after longitudinal Crack pool narrow band, strip of high density, a large number of subarachnoid hemorrhage in longitudinal split pool, lateral fissure pool, basal cistern was cisteria high density mold. Brain parenchymal hemorrhage in 7 cases, CT showed supratentorial parenchyma and ventricles around the multifocal punctate, strip and sheet-shaped high-density, the group of 2 patients with ventricular hemorrhage and subarachnoid hemorrhage. Subdural hemorrhage in 3 cases, CT performance close to the crescent under the crescent-shaped high-density shadow, irregular shape, the group of 3 children were caused by fetal head suction midwifery. Subependymal and intraventricular hemorrhage in 2 cases, CT performance of caudate nucleus near the limitations of high-density small hemorrhage and different degrees of intraventricular hemorrhage, a small amount of bleeding seen in the lateral ventricle angle of high density, the top of the formation of liquid and cerebrospinal fluid level; massive bleeding Performance of one or both ventricle high-density ventricle mold. Epidural bleeding in this group of children was not found, CT skull intracavital lenticular or spindle-shaped high-density film, CT value of 50 ~ 90 Hu, the boundary is clear, the scope of limitations, hematoma generally does not cross the craniotomy. Conclusions The intracranial hemorrhage in neonates mainly includes subarachnoid hemorrhage, cerebral parenchymal hemorrhage, ventricular hemorrhage subarachnoid hemorrhage, and subdural hemorrhage. CT can be diagnosed according to their different manifestations.