摘要
目的:探讨床旁颅脑超声与CT用于高危新生儿颅内出血诊断的临床价值。方法:选取2019年6月-2022年6月于上饶市妇幼保健院收治的新生儿颅内出血82例,同时采取床旁颅脑超声检查和CT检查,以临床表现及头颅磁共振诊断结果作为“金标准”,比较颅脑超声检查和CT检查的敏感度及特异度。结果:床旁超声脑实质出血、硬膜下出血、脑室周围-脑室内出血、蛛网膜下腔出血单项检出率与CT单项检出率差异均无统计学意义(P>0.05),床旁颅脑超声诊断总检出率与CT诊断总检出率比较差异无统计学意义(P>0.05)。临床诊断脑实质出血21例,颅脑超声诊断和CT诊断脑实质出血的敏感度和特异度分别为80.95%、98.36%和85.71%、98.36%;临床诊断硬膜下出血18例,颅脑超声诊断和CT诊断硬膜下出血的敏感度和特异度分别为61.11%、98.44%和77.77%、98.44%;临床诊断蛛网膜下腔出血18例,颅脑超声诊断和CT诊断蛛网膜下腔出血的敏感度和特异度分别83.33%、98.44%和88.89%、96.88%;临床诊断脑室周围-脑室内出血25例,颅脑超声诊断和CT诊断脑室周围-脑室内出血的敏感度和特异度分别92.00%、98.25%和72.00%、94.74%。结论:床旁颅脑超声和CT在新生儿颅内出血的诊断中均有较高的诊断价值,其中诊断硬膜下出血时CT的敏感度高于床旁颅脑超声,而诊断脑室周围-脑室内出血时,床旁颅脑超声的敏感度和特异度均高于CT,针对不同位置的颅内出血可采取不同的诊断方法,但在操作过程中床旁颅脑超声更为快捷方便,可在临床上推广使用。
Objective:To investigate the clinical diagnostic value of bedside craniocerebral ultrasound and CT in the diagnosis of high-risk neonatal intracranial hemorrhage.Method:A total of 82 case of neonatal intracranial hemorrhage who were treated in Shangrao Maternal and Child Health Hospital from June 2019 to June 2022 were selected,and they performed bedside craniocerebral ultrasonography and CT examination.The Clinical manifestations and diagnostic results of magnetic resonance imaging were used as the"gold standard"to compare the sensitivity and specificity of craniocerebral ultrasonography and CT examination.Result:There were no statistical differences in the detection rates of cerebral parenchyma hemorrhage,subdural hemorrhage,periventricularintraventricular hemorrhage,and subarachnoid hemorrhage by bedside ultrasound compared to CT(P>0.05),and there was no statistical significance in the total detection rate between the two examinations(P>0.05).Among 21 cases of clinically diagnosed cerebral parenchymal hemorrhage,the sensitivity and specificity were 80.95%and 98.36%of craniocerebral ultrasound and 85.71%and 98.36%of CT.Among 18 cases of subdural hemorrhage by clinical diagnosis,the sensitivity and specificity were 61.11%and 98.44%of craniocerebral ultrasound diagnosis and 77.77%,98.44%of CT diagnosis.According to clinical diagnosis showed 18 cases of subarachnoid hemorrhage,the sensitivity and specificity were 83.33%and 98.44%of craniocerebral ultrasound and 88.89%and 96.88%of CT diagnosis.Among 25 cases of clinically diagnosed periventricular-intraventricular hemorrhage,the sensitivity and specificity were 92.00%and 98.25%of craniocerebral ultrasound diagnosis and were 72.00%and 94.74%of CT diagnosis of periventricular-intraventricular hemorrhage.Conclusion:Bedside craniocerebral ultrasound and CT have high diagnostic value in the diagnosis of neonatal intracranial hemorrhage.The sensitivity of CT in the diagnosis of subdural hemorrhage is higher than that of bedside craniocerebral ultrasound,while the sensitivity and specificity of bedside craniocerebral ultrasound in the diagnosis of periventricular-intraventricular hemorrhage are higher than those of CT.It is necessary to select the different diagnostic methods for intracranial hemorrhage at different locations.
作者
潘莲英
张琛玉
潘智勇
PAN Lianying;ZHANG Chenyu;PAN Zhiyong(Shangrao Maternal and Child Health Hospital,Jiangxi Province,Shangrao 334600,China;不详)
出处
《中国医学创新》
CAS
2023年第4期144-147,共4页
Medical Innovation of China
基金
上饶市科技指导计划项目(2021CZDX50)。
关键词
床旁颅脑超声
CT
新生儿颅内出血
Bedside craniocerebral ultrasound
CT
Neonatal intracranial hemorrhage
