๋ฉ”์ธ ์ฝ˜ํ…์ธ ๋กœ ๊ฑด๋„ˆ๋›ฐ๊ธฐ
์ฆ๋ก€ #1
ํ™˜์ž ์ •๋ณด: 4 ์ผ, ๋‚จ์„ฑ
์ ์‘์ฆ: ๋ฐฐ์•„๊ธฐ์งˆ ์ถœํ˜ˆ ํ‰๊ฐ€ (24์ฃผ์— ์ถœ์ƒ)

์ฆ๋ก€ #1

์†Œ๊ฒฌ

  • ์ขŒ์ธก ๋ฏธ์ƒ์‹œ์ƒ๊ตฌ์˜ ์—์ฝ” ๋ฐœ์ƒ ๋ฌผ์งˆ๊ณผ ์ขŒ์ธก ์ธก๋‡Œ์‹ค ํ›„๊ฐ์— ์นจ์ „
  • ๋‡Œ์‹ค ํ™•์žฅ ์—†์Œ
  • ๋น„์ •์ƒ์  ๋‡Œ์‹ค์งˆ ์—์ฝ” ๋˜๋Š” ๋‡Œ์™ธ ์ €๋ฅ˜ ์—†์Œ
  • ๋ฏธ์ˆ™์•„ ๋‡Œ๊ณ ๋ž‘ ํŒจํ„ด

์ง„๋‹จ

2๋“ฑ๊ธ‰ ๋ฐฐ์•„๊ธฐ์งˆ ์ถœํ˜ˆ

์ƒ˜ํ”Œ ๋ณด๊ณ ์„œ

์ˆ˜๋‘์ฆ ์—†์ด ์ขŒ์ธก ๋ฏธ์ƒ์‹œ์ƒ๊ตฌ์™€ ์ขŒ์ธก ์ธก๋‡Œ์‹ค ํ›„๊ฐ์— ์นจ์ „๋˜๋Š” ์ขŒ์ธก ๋ฐฐ์•„๊ธฐ์งˆ ์ถœํ˜ˆ(2๋“ฑ๊ธ‰).

๋น„์ •์ƒ์  ๋‡Œ์‹ค์งˆ ์—์ฝ” ๋˜๋Š” ๋‡Œ์™ธ ์ €๋ฅ˜ ์—†์Œ.

๋ฏธ์ˆ™์•„ ๋‡Œ๊ณ ๋ž‘ ํŒจํ„ด.

๊ณ ์ฐฐ

  • ๋ฐฐ์•„๊ธฐ์งˆ์€ ์ฃผ์‚ฐ๊ธฐ ์ŠคํŠธ๋ ˆ์Šค์˜ ๊ฒฐ๊ณผ๋กœ ์ถœํ˜ˆ ์œ„ํ—˜์ด ์žˆ๋Š” ๊ณ ๋„๋กœ ํ˜ˆ๊ด€ํ™”๋œ ๋‡Œ์‹คํ•˜ ๊ตฌ์กฐ์ž…๋‹ˆ๋‹ค
  • ๋ฐฐ์•„๊ธฐ์งˆ์€ ์ž„์‹  3๋ถ„๊ธฐ์— ํ‡ดํ™”ํ•ฉ๋‹ˆ๋‹ค. 32์ฃผ๊ฒฝ์—๋Š” ๋ฏธ์ƒ์‹œ์ƒ๊ตฌ์— ๊ตญํ•œ๋˜๊ณ  36์ฃผ๊ฒฝ์—๋Š” ๋ณธ์งˆ์ ์œผ๋กœ ์†Œ์‹ค๋˜๋ฏ€๋กœ, ์žฌํƒœ 36์ฃผ ์ดํ›„ ์ถœ์ƒ ์˜์•„์—์„œ ๋ฐฐ์•„๊ธฐ์งˆ ์ถœํ˜ˆ์˜ ์œ„ํ—˜์€ ๋ณธ์งˆ์ ์œผ๋กœ 0์ด๊ณ , ๋ฐ˜๋Œ€๋กœ ์›”๊ฒฝ ํ›„ 30์ฃผ ๋ฏธ๋งŒ ์ถœ์ƒ ์˜์•„์—์„œ๋Š” ํฌ๊ฒŒ ์ฆ๊ฐ€ํ•ฉ๋‹ˆ๋‹ค
  • ์ฆ์ƒ์ด ๋“œ๋Ÿฌ๋‚˜์ง€ ์•Š์„ ์ˆ˜ ์žˆ์œผ๋ฏ€๋กœ, ์›”๊ฒฝ ํ›„ 30์ฃผ ๋ฏธ๋งŒ ์ถœ์ƒ ์˜์•„์—์„œ ์„ ๋ณ„ ์‹ ๊ฒฝ ์ดˆ์ŒํŒŒ๊ฐ€ ๊ถŒ์žฅ๋ฉ๋‹ˆ๋‹ค
  • ๋ฐฐ์•„๊ธฐ์งˆ ์ถœํ˜ˆ์„ ์ฐพ์„ ๋•Œ, ๋งฅ๋ฝ์ด(๋ถˆํ–‰ํžˆ๋„ ์ถœํ˜ˆ๊ณผ ์œ ์‚ฌํ•˜๊ฒŒ ์—์ฝ” ๋ฐœ์ƒ)์€ ๋ฏธ์ƒ์‹œ์ƒ๊ตฌ ์ „๋ฐฉ์œผ๋กœ ์—ฐ์žฅ๋˜์ง€ ์•Š์•„์•ผ ํ•˜๋ฏ€๋กœ, ์ „๊ฐ์˜ ์—์ฝ” ๋ฐœ์ƒ ๋ฌผ์งˆ์€ ์ถœํ˜ˆ์ผ ๊ฐ€๋Šฅ์„ฑ์ด ๋†’๋‹ค๋Š” ๊ฒƒ์„ ๊ธฐ์–ตํ•˜์‹ญ์‹œ์˜ค
  • ๋‹ค์Œ์€ ๋ฐฐ์•„๊ธฐ์งˆ ์ถœํ˜ˆ์˜ 4๋“ฑ๊ธ‰์ž…๋‹ˆ๋‹ค:

๋ฐฐ์•„๊ธฐ์งˆ ์ถœํ˜ˆ

๋“ฑ๊ธ‰ ์ถœํ˜ˆ ์œ„์น˜ ์ˆ˜๋‘์ฆ
1 ๋ฏธ์ƒ์‹œ์ƒ๊ตฌ์— ๊ตญํ•œ ์—†์Œ
2 ๋‡Œ์‹ค๋‚ด ์ถœํ˜ˆ ์—†์Œ
3 ๋‡Œ์‹ค๋‚ด ์ถœํ˜ˆ ์žˆ์Œ
4 ๋‡Œ์‹ค์งˆ๋‚ด ์ถœํ˜ˆ ์—†์Œ/์žˆ์Œ
  • ์ˆ˜๋‘์ฆ - ๋‹ค์Œ์€ ์ดˆ์ŒํŒŒ์—์„œ์˜ ๋Œ€๋žต์ ์ธ ์ •์ƒ ์ธก์ • ๊ธฐ์ค€์ž…๋‹ˆ๋‹ค(Brouwer ๋“ฑ). ์ด๋Ÿฌํ•œ ์ธก์ •์˜ ์˜ˆ์‹œ๋Š” ์•„๋ž˜ ์ฃผ์„ ์ด๋ฏธ์ง€์—์„œ ๋ณด์—ฌ์ง‘๋‹ˆ๋‹ค
    • ๋‡Œ์‹ค ์ง€์ˆ˜(๊ด€์ƒ๋ฉด์—์„œ ์ „๊ฐ ์™ธ์ธก๋ฒฝ์—์„œ ๋Œ€๋‡Œ๊ฒธ๊นŒ์ง€์˜ ๊ฑฐ๋ฆฌ) 25-30์ฃผ์— < 10 mm, 40์ฃผ์— < 15 mm
    • ์ „๊ฐ ๋„ˆ๋น„(๊ด€์ƒ๋ฉด์—์„œ ์ „๊ฐ์˜ ์ตœ๋Œ€ ๋Œ€๊ฐ์„  ํญ) 25-30์ฃผ์— < 3 mm, 40์ฃผ์— < 4 mm
    • ์‹œ์ƒ-ํ›„๋‘ ๊ฑฐ๋ฆฌ(์‹œ์ƒ๋ฉด์—์„œ ์‹œ์ƒ ํ›„์—ฐ์—์„œ ํ›„๊ฐ ํ›„์—ฐ๊นŒ์ง€์˜ ๊ฑฐ๋ฆฌ) 25-30์ฃผ์— < 20 mm, 40์ฃผ์— < 25 mm
  • ๋‡Œ๊ฐ€ ์„ฑ์ˆ™ํ•จ์— ๋”ฐ๋ผ ๊ณ ๋ž‘์€ ๋” ๊นŠ๊ณ  ๋งŽ์•„์ง‘๋‹ˆ๋‹ค
  • ํ™˜์ž ์—ฐ๋ น์— ๋Œ€ํ•œ ์ •์ƒ ๊ณ ๋ž‘ ํŒจํ„ด์„ ์ธ์‹ํ•˜๋Š” ๊ฒƒ์€ ๋ฌด๋‡ŒํšŒ์ฆ๊ณผ ๊ฐ™์€ ํ”ผ์งˆ ๋ฐœ๋‹ฌ ์žฅ์• ์˜ ์กฐ๊ธฐ ์ง„๋‹จ์— ์œ ์šฉํ•  ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค
  • ํฐ ๊ณ ๋ž‘/์—ด๊ตฌ(์˜ˆ: ์‹ค๋น„์šฐ์Šค์—ด๊ณผ ๋‘์ •ํ›„๋‘ ๊ณ ๋ž‘)๋Š” ๋ฐœ๋‹ฌ ์ดˆ๊ธฐ์— ๋ช…ํ™•ํ•ด์ง€๋ฉฐ, ๋” ์ž‘์€ ๊ณ ๋ž‘์€ ์ž„์‹  3๋ถ„๊ธฐ ํ›„๋ฐ˜๊นŒ์ง€ ์ดˆ์ŒํŒŒ์—์„œ ๋ณด์ด์ง€ ์•Š์„ ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค
  • ์•„๋ž˜ ์ฃผ์„ ์ด๋ฏธ์ง€๋ฅผ ์ฐธ์กฐํ•˜์—ฌ ์ด ํ™˜์ž์™€ ์›”๊ฒฝ ํ›„ 35์ฃผ ๋ฐ 42์ฃผ์— ์ดฌ์˜๋œ ํ™˜์ž์˜ ๊ณ ๋ž‘ ์ฐจ์ด๋ฅผ ํ™•์ธํ•˜์‹ญ์‹œ์˜ค

์ฃผ์„์ด ์žˆ๋Š” ์ด๋ฏธ์ง€ ๋ฐ ์ผ๋Ÿฌ์ŠคํŠธ

Rounded echogenic area in the left caudothalamic groove (red arrow) consistent with germinal matrix hemorrhage.

Rounded echogenic area in the left caudothalamic groove (red arrow) consistent with germinal matrix hemorrhage.

Echogenic material layering in the occipital horn of the left lateral ventricle (red arrow) consistent with intraventricular hemorrhage.

Echogenic material layering in the occipital horn of the left lateral ventricle (red arrow) consistent with intraventricular hemorrhage.

Example measurements of the ventricular index (A), anterior horn width (B), and thalamo-occipital distance (C).

Example measurements of the ventricular index (A), anterior horn width (B), and thalamo-occipital distance (C).

Coronal image in this patient compared with images from different patients imaged at 35 and 42 weeks. Notice how the echogenic sulci become deeper and more numerous with increasing patient age.

Coronal image in this patient compared with images from different patients imaged at 35 and 42 weeks. Notice how the echogenic sulci become deeper and more numerous with increasing patient age.

์ฐธ๊ณ ๋ฌธํ—Œ

  • Bhat V, Bhat V. Neonatal neurosonography: A pictorial essay. Indian J Radiol Imaging 2014; 24(4): 389-400.
  • Brouwer MJ, de Vries LS, Groenendaal F, Koopman C, Pistorius LR, Mulder EJ, Benders MJNL. New reference values for the neonatal cerebral ventricles. Radiology 2012; 262: 224-233.
  • Chen X, Li SL, Luo GY, Norwitz ER, Ouyang SY, Wen HX, Yuan Y, Tian XX, He JM. Ultrasonographic characteristics of cortical sulcus development in the human fetus between 18 and 41 weeks of gestation. Chin Med J (Engl) 2017; 130(8): 920-928.

    • ์‚ฌ์ดํŠธ ํ”ผ๋“œ๋ฐฑ

    ์—ฌ๋Ÿฌ๋ถ„์˜ ํ”ผ๋“œ๋ฐฑ์€ CaseStacks ๊ฐœ์„ ์— ๋„์›€์ด ๋ฉ๋‹ˆ๋‹ค. ์˜๊ฒฌ, ์ œ์•ˆ ๋˜๋Š” ๋ฐœ์ƒํ•œ ๋ฌธ์ œ๋ฅผ ๊ณต์œ ํ•ด ์ฃผ์„ธ์š”.

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    ํ”ผ๋“œ๋ฐฑ์„ ๋ณด๋‚ด์ฃผ์…”์„œ ๊ฐ์‚ฌํ•ฉ๋‹ˆ๋‹ค. ์†Œ์ค‘ํžˆ ๋ฐ˜์˜ํ•˜๊ฒ ์Šต๋‹ˆ๋‹ค.