磁共振弥散张量成像在早产和足月脑性瘫痪患儿中的应用价值

Application value of magnetic resonance diffusion tensor imaging in premature and full-term cerebral palsychildren

目的探讨磁共振弥散张量成像(DTI)在早产脑瘫和足月脑瘫患儿中的应用价值。方法选取2013年9月至2016年12月安徽省儿童医院确诊的64例脑瘫患儿,依据孕周大小分为早产组32例与足月组32例,运用粗大运动功能量表88项(GMFM-88)评价患儿的运动障碍程度;选取内囊前肢(ICAL)、内囊膝部(ICGL)、内囊后肢(ICPL)、胼胝体膝部(GCC)、胼胝体体部(BCC)、胼胝体压部(SCC)和大脑脚部位作为感兴趣区(ROI),测量弥散各向异性(FA),比较两组不同ROI的FA值;运用Pearson相关分析分析两组各ROI的FA值与GMFM-88分值的相关性。结果早产组的FA值在各部位均小于足月组,右侧ICPL、SCC和双侧大脑脚部位两组差异有统计学意义(P<0.05);早产组DTI内囊前肢、膝部和后肢的FA值和GMFM-88分值之间呈现正相关(P<0.05),其中内囊后肢的相关系数最高(r=0.572,P=0.001);足月组各部位FA值和GMFM-88分值均无显著相关性(P>0.05)。结论早产脑瘫的整体白质发育较足月脑瘫明显延迟;在评价运动功能方面DTI在早产脑瘫中的应用价值高于足月脑瘫患儿。

ObjectiveTo explore the application values of magnetic resonance(MR)diffusion tensor imaging(DTI)in thosepremature and full-term children withcerebral palsy.Methods64children with cerebral palsy,diagnosed in Anhui Provincial Children's Hospital betweenSep2013and Dec2016,were collected anddivided into two groupsaccording to theirgestational weeks:32cases of preterm group and32cases of full-term group.The gross motor function measure88(GMFM-88)was used to evaluate children's degree of dyskinesia.And the anterior limb of internal capsule(ICAL),genu of internal capsule(ICGL),posterior limb of internal capsule(ICPL),genu of corpus callosum(GCC),body of corpus callosum(BCC),splenium of corpus callosum(SCC)and cerebral peduncle(CST)in the brain were selected as regions of interest(ROI)for measurementof diffusionfractional anisotropy(FA).Then the FA values in different ROI related to white matter development between the two groups were compared,and the correlation between FA value and GMFM-88scorein each ROIwas analyzed by Pearson correlation analysis.ResultsTheFA values in all regionsin the preterm group were lower than those in the full-term group,and there were significant differences between themin the right ICPL,SCC and bilateralCST(allP<0.05).In the preterm group,there was positive correlation between FA value and GMFM-88score in the regions ofICAL,ICGL and ICPL(P<0.05),withthe highest correlation coefficientin ICPL(r=0.572,P=0.001).No significant correlation was found between FA value and GMFM-88score in all regions in the full-term group(P>0.05).ConclusionCompared withthosefull-term childrenwithcerebral palsy,the generalwhite matter development in the premature childrenwith cerebral palsyis significantly delayed.The application value of DTI in premature cerebral palsywould behigher than that in full-term cerebral palsy.