儿童皮质发育畸形的MRI诊断

MRI diagnosis of malformations of cortical development of children

目的探讨儿童皮质发育畸形(MCD)的MRI表现特点,为MCD的早期诊断提供依据。方法选择2010年1月至2012年12月在四川省医学科学院·四川省人民医院放射科经MRI检查确诊为MCD的44例患儿为研究对象。回顾性分析及总结其MRI影像学特征。本研究遵循的程序符合四川省医学科学院·四川省人民医院人体试验委员会制定的伦理学标准,得到该委员会批准,征得受试对象及其监护人知情同意,并与监护人签署临床研究知情同意书。结果本组44例经MRI确诊为MCD患儿中,巨脑回-无脑回为17例,多小脑回为14例,灰质异位为9例,脑裂畸形为4例。MCD的MRI特点中,巨脑回表现为脑回增宽、皮质增厚及白质变薄;无脑回表现为正常脑沟、脑回消失,皮质增厚及白质变薄;多小脑回表现为脑回增多、细小;灰质异位表现为皮质下及侧脑室周围深部白质区结节状、团块状或带状病灶,信号与灰质信号相同;脑裂畸形表现为从侧脑室到脑表面贯穿大脑半球的裂隙,表面覆盖灰质。结论 MRI是诊断儿童MCD的可靠影像学方法。

Objective To explore the characteristics of MRI appearances of malformations of cortical development（MCD）in children,so as to provide evidence for early diagnosis of MCD.Methods A total of44 children who were made a definite diagnosis as MCD by MRI in department of Radiology,Sichuan Academy of Medical Sciences Sichuan Provincial People′s Hospital from January 2010 to December 2012 were chosen as study subjects.The characteristics of MRI were summarized and analyzed retrospectively.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Sichuan Academy of Medical Sciences Sichuan Provincial People′s Hospital.Informed consent was obtained from the parents of each participant. Results There were 17 cases of pachygyria-agyria,14 cases of polymicrogyria,9cases of grey matter heterotopia and 4cases of schizencephaly in these 44 cases MCD children.MRI features of pachygyria were included gyri broadened,cortex thickened and white matter thinningz.MRI features of agyria were included the sulci was normal,gyri disappeared,cortex thickened and white matter thinningz.MRI features of polymicrogyria were included the number of gyri was increased but the volume was decreased.MRI features of grey matter heterotopia were included nodosity,masses and barred lesion located at subcortical areas and deep white matter of periventricular regions,the signal intensity was similar to that of normal grey matter.MRI features of schizencephaly were included grey matter covered clefts which go through cerebral hemisphere from lateral ventricles to hemispheric surface.Conclusion MRI is a reliable method to the diagnosis of pediatric MCD.