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新生儿缺氧缺血性脑病与围产期多因素相关,影像学检查是临床诊治及判断患儿预后不可缺少的手段。目前常用于新生儿颅内疾病诊断的影像学方法为超声、CT和MRI,方法各有长处,同时存在各自局限性。超声是围产期检查的首选方式,但对微小病变、蛛网膜下腔出血及硬脑膜下出血分辨率极差。CT对颅内出血诊断率最高,但有辐射。磁共振成像技术发展迅速,弥散加权成像(DWI)对梗塞敏感;弥散张量成像(DTI)能更好地显示白质改变,波谱无创,还可监测代谢状态;磁敏感加权成像(SWI)对微量出血敏感,却耗时长、噪声大。合理运用各种影像学检查,扬长避短,相互验证,指导临床及时早期干预,有助于减少永久性脑损害和神经系统后遗症的发生。
Neonatal hypoxic-ischemic encephalopathy is associated with multiple factors of perinatal period. Imaging examination is an indispensable means for clinical diagnosis and treatment of children with prognosis. Currently used in the diagnosis of neonatal intracranial imaging methods for ultrasound, CT and MRI, each has its own strengths, while their respective limitations. Ultrasound is the preferred method of perinatal examination, but poor resolution of minimal change, subarachnoid hemorrhage and subdural hemorrhage. CT diagnosis of intracranial hemorrhage the highest rate, but there is radiation. Magnetic resonance imaging has developed rapidly and DWI is sensitive to infarction. DTI can better show the change of white matter, noninvasive spectrum and monitor the metabolic status. Magnetic susceptibility weighted imaging (SWI) Sensitive bleeding, but time-consuming, noisy. Reasonable use of a variety of imaging studies, strengths and circumvent weaknesses, mutual verification, and clinical early intervention in a timely manner to help reduce the permanent brain damage and neurological sequelae.