Comparison Of Medical Imaging Investigations In The Diagnosis And Prognosis Of Neonatal Brain Injury

Objective To explore the features of Cranial ultrasound,CT scan and MRI for the diagnosis of Hypoxic-ischemic brain injury in neonates after asphyxia and a comparative analysis of their prognosis.Methods Cranial Ultrasound,CT scan and MRI examination were performed simultaneously on 38 early neonates who were admitted into neonate unit in affiliated hospital of North Sichuan medical college from Jan.2005 to Dec.2007.They were diagnosed as bhypoxic-ischemic encephalopathy(HIE)(moderate and sever stage) after definitive asphyxia. Some of them were re-examinated according to docter's decision.Thirteen cases of normal early neonates at the same time were as control group.The patient infants in the hospital two or three weeks then discharge,and to continue with hyperbaric oxygen therapy three courses,each course of 10 days,for six consecutive months,and followed up to one-year of life. Neonatal behavior neurological assessment(NBNA) was performed at 12 to 14 days after birth.Development quotient(DQ) was used to evaluate their prognosis at age of three month to one year. Results MRI and CT scan of brain lesions on the over all display is better than Cranial Ultrasound,with sensitivity of CT 81.58%,MRI 94.74%,Cranial Ultrasound 55.26%,respectively.However,for intracranial hemorrhage,the diagnosis rate of CT scan was 94.44%,MRI was 83.33%,Cranial Ultrasound only 61.11%.Of 36 cases of cerebral edema revealed by MRI,21 cases showed cerebral edema by cranial ultrasound,with concordance rate of 58.82%.Periventricular leukomalacia(PVL) were consistent rate of 22.22%both them.Five damages including basal ganglia＆hypothalamus injury,perisagittal area injury,periventricular hemorrhage(PVH)- IVH + PVL,PVH-IVH and subarachnoid hemorrhage(SAH)+ subdural hematoma(SDH) have much more possibility of sequelae,we could not determine which imaging investigation is best to determine the prognosis of HIBI.Conclusion All of cranial ultrasound,CT scan and MRI can be use as diagnosis of hypoxic ischemic brain injury.Cranial ultrasound was preliminary and follow-up method.MRI examination suit checking the severe and encephalopathy outstanding performance of hypoxic ischemic brain injury in newborns.Intracranial hemorrhage suspected in newborns would select brain CT scan...