目的分析早产儿围生期窒息颅 脑CT表现特点。方法 回顾性分析50例围 生期窒息新生儿临床资料，比较不同胎 龄(早产儿26例，足月儿24例)、不同窒 息程度早产儿的颅脑CT表现、新生儿行为 神经测定评分(NBNA)、脑白质CT值。结 果 26例早产儿可见脑实质密度弥漫性降 低(CT值＜16 Hu)，蛛网膜下腔出血，24 例足月儿均为脑皮质与皮质下白质低密度 灶(CT值＜18 Hu)，累及脑室周围白质， 可合并蛛网膜下腔出血；早产儿NBNA评 分、脑白质CT值低于足月儿(P＜0.05)； 轻度窒息组NBNA评分、脑白质CT值高于 重度窒息组，脑白质损伤率低于重度窒 息组(P＜0.05)；围生期窒息早产儿NBNA 评分与脑白质CT值呈正相关(r=0.352，P ＜0.05)。结论 窒息对不同发育阶段脑组 织病理损害不同，其中围生期窒息早产儿 颅脑CT病变集中于脑室周围白质，随窒息 程度加重，脑白质损伤更严重。

Objective To analyze the brain CT features of perinatal asphyxia in preterm infants. Methods The clinical data of 50 neonates with perinatal asphyxia were analyzed retrospectively. Brain CT findings,neonatal behavioral neurological assessment (NBNA) scores and CT value of brain white matter were compared between infants of different gestational age (26 premature infants, 24 term infants) and infants with different degrees of asphyxia. Results There were diffusely reduced density of cerebral parenchyma (CT value < 16Hu) and subarachnoid hemorrhage in 26 premature infants. There were cortical and subcortical white matter low-density lesions (CT value < 18Hu), involvement of periventricular white matter and subarachnoid hemorrhage in 24 term infants. The NBNA score and CT value of white matter of premature infants were lower than those of term infants (P<0.05). The NBNA score and CT value of white matter of mild asphyxia group were higher than those of severe asphyxia group (P<0.05), while the rate of white matter damage was lower than that in severe asphyxia group (P<0.05). The NBNA score was positively correlated with the CT value of white matter in premature infants with perinatal asphyxia (r=0.352, P<0.05). Conclusion Asphyxia has different pathological damage to brain tissues at different stages of development. CT lesions in premature infants with perinatal asphyxia is mainly located in brain white matter around the ventricles. With the aggravation of asphyxia, white matter damage becomes more severe.