嬰兒腦部弧形真實時間超音波掃描之研究

Two-Dimensional, Real-Time Ultrasonographic Imaging of the Brain in Infancy

謝凱生(Kai-Sheng Hsieh) ； 劉錦理(Kin-Lee Liu) ； 遲景上(Ching-Shiang Chi) ； 黃棣棟(Tai-Tong Hwang)

《Acta Paediatrica Sinica》 24卷4期 (1983/12) Pp. 268-274

摘要

作者於本文報告腦部瞬時弧形超音波在嬰兒時期之臨床應用。實際上，經前囪門腦部超音波掃描適用於所有前囪門未閉合之嬰兒。至於經由顱骨側面之掃描方式，於新生兒可行，但嬰兒至3、4月齡以上卽不易獲致清晰影像自1981年7月l向至1982年7月31日，作者以經前囪門之腦部弧形超音波掃描，檢查所有住入小兒病房1月齡以上前囪門未閉合，臨床懷疑有顱內器質性病灶之嬰兒。並儘可能在做腦部超音波檢查之24小時以內，做電腦斷層攝影以資對照參考。腦部弧形超音波掃描異常者計有17例，均經電腦斷層攝影佐證，計有腦室擴大、先天性顱內囊腫（Dandy-Walker囊腫、蛛網膜腔囊腫)、腦室炎、腦萎縮、後顱窩出血、側腦室畸胎瘤、硬腦膜下腔積水等。作者對上述各病例均詳細說明其超音波圖形之變化。此研究顯示多數病變以標準之冠狀面，矢狀面掃描約可診斷，但對於後顱窩之病灶、必須使用修正式冠狀面掃描以資診斷，對於腦部表淺性病灶，須使用水袋置於轉能器與顱頂間以避免近野幹擾。作者認為腦部超音波掃描因具有某些限制，諸如析像力不若電腦斷層攝影清晰，無對照劑增強效果等等。但鑑於其具非侵襲性，操作簡便，可反覆檢查無虞放射線侵害等優點，仍具有甚大之發展潛力。

並列摘要

The authors report the application if two-dimensional real-time bran imaging in imaging through the anterior fontannel. In the infants older than four months of age, the skull is often too allow mineralized to allow adequate penetration of the ultrasound, Therefore, brain imaging through the anterior fontannel is the preferred route for ultrasonic examination infants. Since July 1, 1981, the authors examined infants older than one month of age with suspected structural intracranial lesions by sector ultrasound if their anterior fontannels were still open Computed tomography was performed within 24 hours of the ultrasonic examinations. The images of the computed tomography and ultraound were compared in detail. The lesions which yielded abnormal findings were hydrocephalus congenital intracranial cystic lesion (Candy Walker cyst, arachnoid cyst), ventriculitis, brain atrophy, posterior fossa hemorrhage subdural effusion and intraventricular tumor. To achieve the best result, multiple imaging planes it eluding the coronal, saggital arid modified coronal planes should be used, A water bag placed between the transducer and sea p was found to he of help in imaging the suspected superficial lesions of the brain Disadvantages of ultrasonic brain imaging as compared with computed tomography of the brain are lad of high resolution and unavailability of contrast enhancement, However, despite these disadvantages, the noninvasiveness, the portability and lack of radiation exposure make this technique increasing important for diagnostic screening and follow-up of brain lesions of infants.

並列關鍵字

ultrasonographic imaging ； brain