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目的探讨超声声脉冲辐射力成像技术(ARFI)评价缺氧缺血后新生儿早期脑损伤的临床应用价值。方法选择2009年1月至2010年1月出生3天内入住我院新生儿重症监护病房的适于胎龄儿,足月HIE组、早产脑损伤组、足月对照组和早产对照组各40例。采用SiemensAcuson S2000超声诊断系统,生后4～7天常规行颅脑二维超声及彩色多普勒检查,于ARFI模式下启动声触诊组织量化(VTQ)功能测量颅脑双侧顶叶、丘脑及大脑镰的VTQ值,并对各组进行比较。结果 (1)足月HIE组及早产脑损伤组双侧顶叶及丘脑、大脑镰VTQ值均大于同胎龄对照组(P均<0.05)。(2)早产儿脑损伤组双侧顶叶及右侧丘脑VTQ值大于足月HIE组(P均<0.05)。(3)早产对照组双侧顶叶VTQ值大于足月对照组(P均<0.05)。(4)VTQ值随足月儿HIE病情加重呈增加趋势。结论 ARFI能实时、敏感探测新生儿脑部不同部位正常与病变时VTQ值,有望成为新生儿特别是早产儿脑损伤早期诊断手段之一。
Objective To investigate the clinical value of ultrasound-guided pulsed radiation imaging (ARFI) in assessing neonatal brain injury following hypoxia-ischemia. Methods Forty 40-month-old HIE group, premature brain injury group, full-term control group and preterm birth control group were enrolled in neonatal intensive care unit in our hospital within 3 days of birth from January 2009 to January 2010. . Using SiemensAcuson S2000 ultrasonic diagnostic system, 4 to 7 days after birth, routine brain ultrasound and color Doppler ultrasound examination in ARFI mode to start the acoustic palpation Tissue Quantification (VTQ) function measurement of bilateral parietal lobe, thalamus And the falx of the VTQ value, and compare each group. Results (1) VTQ values of bilateral parietal lobe, thalamus and falx cerebellum in term HIE group and preterm birth brain injury group were all greater than that in gestational age (all P <0.05). (2) VTQ values in bilateral parietal lobe and right thalamus of premature infants with brain injury group were higher than those of full-term HIE group (all P <0.05). (3) VTQ value of bilateral parietal lobe in preterm labor control group was higher than that in term control group (all P <0.05). (4) VTQ value increased with the increase of full-term neonatal HIE. Conclusions ARFI can detect the VTQ value of different parts of normal and diseased brain in real time and sensitively, which is expected to be one of the early diagnostic methods for neonatal, especially premature infants with brain injury.