磁共振成像在儿童脑性瘫痪诊断中的价值

Diagnostic value of magnetic resonance imaging in children with cerebral palsy

目的探讨磁共振成像在儿童脑性瘫痪中的诊断价值。方法回顾性分析46例被临床确诊脑瘫患儿的病史和磁共振表现,并选择20例年龄、性别相匹配的健康儿童进行对照研究。常规颅脑磁共振扫描后,行脑的DTI检查,得到FT图及FA图。结果 46例脑瘫患儿中,7例常规颅脑磁共振扫描未见异常,兴趣区纤维束变化不明显,但各向异性FA值轻度降低。39例常规磁共振表现异常中,脑室周围白质软化症23例,弥漫性脑白质损伤16例,其中伴有胼胝体萎缩3例,脑裂畸形2例、脑萎缩5例。白质软化症和脑白质损伤DTI/FT显示神经纤维束局部或弥漫稀疏、缺失及走行方向异常。结论磁共振成像可明确儿童脑性瘫痪的病因、部位及病变程度,特别是DTI/FT有助于发现隐蔽性脑白质损伤,为临床制定合理治疗方案提供明确的依据。

Objective To explore the diagnostic value of magnetic resonance imaging（MRI） in children with cerebral palsy. Meth- ods The perinatal history and MRI data of 46 cases children with cerebral palsy confirmed by hospital were retrospectively analyzed, and 20 healthy children were selected as control, the age and gender were matched between the two groups. Results In all 46 children with cerebral palsy, 7 cases showed normal on conventional MRI, fiber tracts in region of interest （ROI） closed to normal, but the corresponding fractional anisotropy （FA）values were reduced. Twenty -three cases appeared periventricular leukomalacia, 16 appeared white matter damage, among whom 5 cases were with brain atrophy, 2 cases with schizencephaly, and 3 cases with corpus callosum atrophy. Fiber tracts of periventricular leukomalacia and white matter damage showed injury in different degrees. Conclusion MRI scan is useful in revealing etiology, location and degree of brain pathological changes in children with cerebral palsy. Specially, diffusion tensor imaging （DTI）/fiber tractography （FT）can find slight brain white matter damage, which provides evidence for clinically drawing up reasonable treatment scheme.