Values Of Color Doppler Ultrasound To Early Diagnosis Of Brain Injury In Neonates And Its Related Risk Factors

Objective: To explore the values of color Doppler ultrasound to early diagnosis of brain injury in neonates and to analyze the related risk factors of this disease,providing basis for early diagnosis and treatment in clinic,improving prognosis of these neonates.Methods:1 A case-control study was conducted at Neonatal Intense Care Unit(NICU)of department of Pediatrics in the Fourth Hospital of Hebei Medical University in China from January to December 2016.92 neonates with brain injury were selected as case group,who were divided into two groups:the mild and the moderate to severe groups.42 neonates without brain injury during the same period were randomly selected as control group.All these neonates received cranial ultrasound for the first time within 3 days after birth to detect intracranial structure and the brain blood flow.And all the cerebral hemodynamics parameters of bilateral Middle Cerebral Artery(MCA),which include Peak Systolic Velocity(PSV),End Diastolic Velocity(EDV)and Resistance Index(RI)were measured via Color Doppler Flow and compared among the groups.2 A case-control study was conducted at Neonatal Intense Care Unit(NICU)of department of Pediatrics in the Fourth Hospital of Hebei Medical University in China from January to December 2016.92 neonates with encephalopathy were selected as case group and 84 neonates without encephalopathy during the same period were randomly selected as control group.The clinical data correlated with encephalopathy of these cases were collected and analyzed retrospectively.Finally 15 related risk factors of encephalopathy were included,which were gestational age(GA),birth weight(BW),neonatal asphyxia,fetal distress,parity,delivery mode,amniotic fluid meconium,premature rupture of membrane,placentalabruption,hypertensive disorder complicating pregnancy,gestational diabetes mellitus(GDM),Apgar score,acidosis,scarred uterus and irregular prenatal examination.Univariate Logistic regression analysis and multivariate Logistic regression analysis were used to analyze the related risk factors of encephalopathy.Results:1.1 The results of 2-D cranial ultrasonography(c US)All these neonates received cranial ultrasound for the first time within 3days after birth.According to the results of 2-D c US,51 cases of the mild group were abnormal(51/81).The classic c US findings of mild group based on cerebral edema included focally periventricular echodensities and narrowing of lateral ventricle.The echogenicity was lower than choroid plexus.There were 7 cases with subependymal cyst,2 cases with subependymal hemorrhage(SEH),3 cases with intraventricular hemorrhage(IVH).9 cases of the moderate to severe group were abnormal(9/11).The classic c US signs included diffusely increased periventricular echogenicity equal to or higher than choroid plexus,slitlike ventricles,obliteration of the extracerebral cere-brospinal fluid spaces and the interhemispheric fissure,blurring of the brain structure and also the ill defined boundary between the sulus and gyrus.There were 2 cases with subependymal cyst,1 case with periventricular hemorrhage infarction(PVHI),1 case with Periventricular leukomalacia(PVL).c US findings were normal in 42 neonates of control group.1.2 The results of Color Doppler Flow cranial ultrasonography(c US)of MCAThe cerebral haemodynamics parameters of bilateral MCA of all the134 neonates were measured.The Color Doppler Flow c US results showed that there was significant difference in PSV and EDV of MCA between the case group and control group(P<0.05).The more severe the encephalopathy was,the lower the PSV and EDV were.There were statistical differences in RI of MCA among three groups except RI between the mild group and thecontrol group.The more severe the encephalopathy was,the higher the RI was.2.1 Single factor analysis of related risk factors of encephalopathyThe results of single factor analysis showed that there were statistical differences in 9 related factors of encephalopathy between two groups(P<0.05).These related factors were BW,neonatal asphyxia,fetal distress,delivery mode,amniotic fluid meconium,placental abruption,Apgar score,acidosis and irregular prenatal examination.2.2 The results of multivariate Logistic regression analysisThe related factors of encephalopathy were BW,fetal distress,placental abruption,acidosis and irregular prenatal examination.BW was protective factor while others were risk factors.Conclusions:1 c US,using Color Doppler Flow on the basis of 2-D,is of great value in early diagnosing of brain injury in neonates.2 The results of multivariate Logistic regression analysis shows that BW,fetal distress,placental abruption,acidosis and irregular prenatal examination are related factors of encephalopathy ultimately.BW is protective factor while others are high risk factors.Early clinical intervention of those neonates with these risk factors is of great help for improving prognosis.3 The etiology of encephalopathy in neonates is complex and diverse,which can be affected by not only perinatal ischemic-hypoxic,but also maternal,fetal,delivery,neonatal and social factors.Comprehensive analysis and evaluation is necessary for treatment.Long-term follow-up and valuable prognostic information should be insisted.