PVL脑瘫患儿MRI分级与粗大运动功能分级的相关性分析

Correlation between MRI classification and gross motor function classification in children with PVL cerebral palsy

目的探讨PVL脑瘫患儿MRI分级与粗大运动功能分级(GMFCS)的相关性。方法回顾性分析76例经磁共振诊断为PVL的脑瘫患儿,所有患儿均行MRI常规扫描,并进行GMFCS分级评估。基于横轴位T2WI/T2Flair,正中矢状位T2WI观察病变。由两名具有儿科影像诊断经验的医师分别独立评价PVL脑瘫患儿的磁共振图像,采用Kappa一致性检验,评价观察者间的一致性,Spearman相关分析评价PVL脑瘫患儿的MRI分级与GMFCS分级的相关性。结果本组76例PVL脑瘫患儿中,PVL分级(Ⅰ级1例,Ⅱ级63例,Ⅲ级12例),两观察者间的一致性Kappa值0.869(P<0.05);GMFCS分级(I级20例、Ⅱ级12例、Ⅲ级16例、Ⅳ级11例、Ⅴ级17例),PVL的MRI分级与GMFCS分级(r=0.605,P<0.05)呈正相关。结论PVL的MRI分级可以重复性评价脑瘫患儿的损伤程度,可以通过常规MRI初步判断脑瘫患儿的粗大运动功能损伤程度,对临床预后进行初步预判及评估。

Objective To explore the correlation between MRI classification and gross motor function classification(GMFCS)in children with PVL cerebral palsy.Methods A retrospective analysis of 76 cases of MRI diagnosis of PVL in children with cerebral palsy was conducted,all patients underwent conventional MRI scanning,and GMFCS grading.Based on axial T2WI/T2Flair,median sagittal T2WI,the lesion was obseved.Two physicians with pediatric imaging experience independently evaluated the magnetic resonance imaging of children with PVL cerebral palsy.Kappa consistency test was used to evaluate the consistency among observers,Spearman correlation analysis was used to evaluate the correlation between MRI classification and GMFCS classification in children with PVL cerebral palsy.Results Among 76 children with PVL cerebral palsy,PVL(1 case of gradeⅠ,63 cases of gradeⅡ,12 cases of gradeⅢ),showed a consistent Kappa value of 0.869 between the two observers(P<0.05).GMFCS grading(grade 20 cases of gradeⅠ,12 cases of gradeⅡ,16 cases of gradeⅢ,11 cases of gradeⅣ,17 cases of gradeⅤ),there was a positive correlation between PVL grading and GMFCS grading(r=0.605,P<0.05).Conclusion MRI grading of PVL can be used to evaluate the degree of injury in children with cerebral palsy repeatedly.Routine MRI can be used to evaluate the degree of gross motor function injury in children with cerebral palsy and to predict and evaluate the clinical prognosis.