164例儿童脑性瘫痪的CT分析

CT Analysis of 164 Cases of Cerebral Palsy

本文回顾性研究了１６４例儿童脑瘫（ＣＰ）的脑部ＣＴ表现，发现异常者１５１例，占９３％。ＣＴ异常表现；①脑室周围白质软化（ＰＶＬ），容量减少（１２４／１３７）；②脑室扩大，变形（１１４／１３７）；③脑室外脑脊液（ＣＳＦ）间隙增宽（８７／１３７）；④脑实质内低密度区（１２／１３７）。⑤其它如先天性脑畸形（２７／１３７）等。这些异常所见与患者临床表现关系密切。本研究显示了影像学检查对ＣＰ的诊断价值．突出了ＰＶＬ及其后遗改变在ＣＰ发病学中的作用。文中资料表明，早产可能是重度脑白质丧失的最重要因素；大脑纵裂中后份增宽是重度脑组织丧失的征象；出生后脑缺血缺氧可能是ＣＰ患儿重度脑室扩大的主要原因；ＣＰ患儿脑部病变以一侧为主者常表现为对侧肢体不同程度中枢性瘫痪。

Retrospective evaluation of CT inverstigations in 164 children with cerebral palsy has revealed abnormalities in 93%.The specific CT abnormalities were:(1) white matter hypoplasia.and/or reduction (124/137);(2)ventriculomegaly with deformations (114/137 );(3) extraventricular CSF space dilatation (87/137);(4)localized juxtavertricular hypodensities (12/137) .and (5)27 childern with congenital malformations accompanied by some degree of PVL. These all show close relationship to the clinical handicap (i. e. ADL disablity) of the patients with CT pathology. There observations not only demonstate the value of image in the diagnosis of CP,but also highlight the role of PVL. in the genesis of CP and well. Premature birth possibly is the PVL greatest risk factor resulting in extensive white matter loss. Widening the middle and posterior part of the longitudinal fissure may be an associated sign of serious cerebral tissue/white matter loss. That postnatal hypoxia-ischemia may be the primary cause resulting in extensive vertruculomegaly in children with CP.