儿童大脑的计算机断层扫描。我1。围产期血管性脑病。2. 先天性脑畸形]。

Z Cernoch, M Sercl, J Parízek, J Lichý
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引用次数: 0

摘要

本文对103例血管病变儿童(15岁以下)和59例先天性脑小脑畸形儿童的CT表现进行了评估。由于缺氧和缺血性脑损伤,它们的最大限度被认为发生在围产期。因此,大多数诊断问题与低密度未成熟脑与缺血性改变的区分有关。上述发现均与临床病程相关。类似的对抗和早期的CT对照检查可能有助于区分轻微的暂时性脑缺血后水肿和严重的坏死性和恶性变化。在年龄较大的儿童中,由于病因不同,血管病变很少发生。出血血管病变的CT表现更为明确。其发病特别重要的是缺氧发作,随后静脉出血主要进入萌发基质。虽然早产新生儿耐受性良好,但足月新生儿广泛出血预后较差,导致对照检查发生显著变化,主要表现为脑积水和脑瘫。不同程度的脑萎缩是血管性脑病最常见的结果。在几乎一半的先天性脑和小脑异常中,主要在透明隔中发现较小的中线腔。从严重的发现来看,最常见的是不同类型的发育不良,胼胝体发育不足直至发育不全,有时合并脂肪瘤或囊肿。另一表现为Dandy-Walker小脑畸形、全前脑,仅有2例患者表现为脑积水和基底膜脑膨出。为了阐明上述结构之间的最终通信,大多数诊断工作主要集中在与脑室肥大和/或囊性形成相关的异常上。此外,CT脑室-膀胱-睾丸造影也使用少量的非离子造影剂进行。目前,CT检查的重要部分可能被超声检查所取代,超声检查更简单,适用于新生儿和幼儿。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Computer tomography of the brain in children. I. 1. Perinatal encephalopathy of vascular origin. 2. Congenital brain malformations].

CT findings are evaluated in 103 children with vascular lesions (aged up to 15 years), and in 59 children with congenital cerebral and cerebellar malformations. Their maximum has been stated to occur perinatally due to hypoxic and ischemic brain affections. Therefore most of diagnostical problems were related to the differentiation of hypodense immature brain from ischemic changes. Mentioned findings were always correlated with clinical course. Similar confrontations along with earlier CT control examination may be helpful in distinguishing milder transitory postischemic oedema from serious necrotic and malatic changes. In more aged children, vascular lesions are of rare occurrence being different in etiology. More unambiguous CT patterns are obtained in vascular changes with hemorrhagies. Of special importance in their onset is a hypoxic attack with subsequent venous bleeding mainly into the germinative matrix. While well tolerated in premature newborns, the extensive hemorrhagies in on-term ones have worser prognosis, resulting in significant changes on control examination, predominantly hydrocephalus and porencephalia. Atrophies of various extent were the most common consequence of all encephalopathies of vascular origine. In almost a half of congenital brain and cerebellar anomalies, unsignificant findings of smaller middle line cavities were obtained predominantly in pellucide septum. From the serious findings, most frequent were different varieties of dysgenesis, hypogenesis up to agenesis of corpus callosum combined sometimes with either the lipomas or cysts. Another findings consisted in Dandy-Walker's cerebellar malformation, holoprosencephalia and only two patients manifested hydrencephalia and basal meningoencephalocele. Most of diagnostical effort has been made in mainly anomalies associated with ventriculomegalia and/or cystic formations in order to elucidate the eventual communication between the structures mentioned. In addition, CT ventriculo-cysto-orcisternography has also been performed using smaller amount of nonionic contrast. At present, an important portion of CT examinations may be replaced with sonography which is more simple as used in both newborns and toddlers.

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