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目的 探讨新生儿及小婴儿脑动脉梗塞的B超、CT和MRI影像诊断特点。方法 1998年 12月至2000年 2月期间,对入住上海新华医院新生儿病区的新生儿及小婴儿同时进行头颅B超、CT和MRI检查,并酌情复查。结果 5例足月小婴儿被诊断为脑动脉梗塞,其中重度窒息 2例,轻度窒息 1例,均在新生儿期后 0. 5~3个月因惊厥收住院。脑动脉梗塞部位涉及大脑前、中、后动脉所分布区域,以左侧中动脉梗塞较为常见。B超可清晰诊断脑动脉梗塞的早期(强回声)和晚期(低回声),但未能诊断大脑后动脉梗塞;CT和MRI对整体颅脑病变的显示优于B超,但对脑动脉梗塞的早、晚期则均呈现相同的低密度或T1 低信号。结论 B超、CT和MRI均可诊断脑动脉梗塞,其中B超可床边检查,对颅脑中央部位的病变分辨力高,应为新生儿颅内病变的首选影像诊断方法。
Objective To investigate the features of B-ultrasound, CT and MRI in diagnosis of cerebral infarction in neonates and infants. Methods From December 1998 to February 2000, newborns and infants admitted to Xinhua Hospital of Shanghai were examined by B-mode ultrasound, CT and MRI at the same time, and reviewed as appropriate. Results Five full-term infants were diagnosed as cerebral artery infarction. Among them, severe asphyxia in 2 cases and mild asphyxia in 1 case were all admitted to hospital after convulsions from 0.5 to 3 months after neonatal period. Cerebral artery infarction involving the brain before and after the artery distribution area to the left middle artery infarction is more common. B ultrasound can clearly diagnose the early (hyperechoic) and late (hypoechoic) cerebral infarction, but failed to diagnose posterior cerebral artery infarction; CT and MRI showed better overall brain lesions than B ultrasound, but cerebral infarction The early and late stage showed the same low density or T1 low signal. Conclusion B-scan, CT and MRI can diagnose cerebral infarction. B-scan can detect the lesion in the central part of the brain, and should be the first choice of imaging diagnosis for intracranial lesions in neonates.