儿童脑室周围白质软化症的临床和MRI诊断

Clinical and MRI diagnosis of periventricular leukomalacia in children

目的探讨儿童脑室周围白质软化症（ＰＶＬ）的ＭＲ征象及与临床表现的关系。方法回顾性分析１５例ＰＶＬ的临床资料和ＭＲ表现。结果（１）脑白质减少单纯在三角部周围９例，三角部和半卵圆中心３例，体部周围１例。（２）Ｔ２ＷＩ白质内高信号在侧脑室额角、体部和三角部周围的白质中，仅１个部位者５例，２个部位者５例，三个部位同时受累者５例。另４例伴有小的软化灶和囊变区。（３）７例有侧脑室扩大，４例伴有侧脑室形态不规则。（４）８例显示双侧外侧裂加深增宽。（５）５例出现胼胝体异常。（６）根据ＭＲ征象，将ＰＶＬ分为轻、中和重度３度，本组属于轻、中、重度者各５例。结论ＭＲ可清楚显示ＰＶＬ的病变程度和范围，水抑制序列显示病变更清楚。

Purpose To study the MRI features of children periventricular leukomalacia(PVL) and correlate with clinic. Methods The clinic and MRI fingings of 15 cases of PVL were retrospectively analyzed. Results (1) Quantitative reduction of white matter only peritrigonal 9 cases, at trigonal and semiovale center 3 cases, periventricular body 1 case. (2) T 2WI signal hyperintensity in white matter was around frontal angle, body and trigonal of ventricular, only one place was 5 cases, two places 5 cases and three places 5 cases. 4 cases have small cerebral soften and cystic degeneration. (3) 7 cases ventricular enlarged, 4 cases appearance irregular. (4) 8 cases bilateral lateral fissure deepen and widen. (5) 5 cases corpus callossum abnormity. (6) The degree was classified into three degrees based on MRI appearance of PVL, mild, middle and severe degrees all were 5 patients. Cunclusion Level and scope of focus of PVL can been clearly displayed by MR imagings, clinical manifestation was closely related to limits of focus of PVL in MR imagings.