磁共振3D-T1WI高分辨成像在儿童局灶性皮质发育不良Ⅰ型中的应用

The application of 3D-T1 WI high-resolution magnetic resonance imaging in children with focal cortical dysplasia typeⅠ

目的探讨3D-T1WI高分辨MR成像在儿童局灶性皮质发育不良(FCD)Ⅰ型中的价值。方法回顾性分析2016年7月至2018年7月收治的26例经手术治疗病理证实的FCDⅠ型患儿的MRI资料,比较3D-T1WI序列与其他序列对FCDⅠ型患儿主要MRI征象(灰白质分界模糊、局灶性皮质结构异常及白质内异常信号灶)检出情况及FCDⅠ各亚型之间不同MRI征象的出现率。计算3D-T1WI序列检出的各方位局灶性灰白质分界模糊及皮质结构异常例数及连续层数。结果3D-T1WI对灰白质分界模糊的检出率(92.3%)明显高于3D-T2FLAIR(61.5%)和常规T1WI(42.3%)(P均<0.017),3D-T1WI对局灶性皮质结构异常的检出率(69.2%)明显高于常规T1WI(26.9%)(P<0.017),对白质内异常信号灶的检出率三种序列差异无统计学意义(P>0.05)。各亚型之间不同MRI征象的出现率差异均无统计学意义(P均>0.05)。在轴位、冠状位及矢状位,3D-T1WI检出灰白质分界模糊病变连续层数均≥3层,检出局灶性皮质结构异常连续层数均≥2层。结论3D-T1WI可提高对儿童FCDⅠ型的检出率,为首选MRI检查序列。

Objective To explore the value of high-resolution 3-dimensional T1-weighted imaging(3 D-T1 WI) in children with focal cortical dysplasia(FCD) of type Ⅰ.Methods The MRI data of 26 pathologically confirmed FCD type Ⅰ children admitted from July 2016 to July 2018 were retrospectively analyzed, and the 3 D-T1 WI sequence was compared with other sequences for the main MRI signs of FCD type Ⅰ children(blurred gray-white matter junction, focal cortical structure abnormalities and abnormal signal focus in white matter) detection status and the occurrence rate of different MRI signs among FCD Ⅰ subtypes. The number of cases and the number of consecutive layers with local blurred gray-white matter junctions and cortical structural abnormalities detected by 3 D-T1 WI sequence in each plane calculated.Results The detection rates of blurred gray-white matter junction by 3 D-T1 WI(92.3%)were obviously higher than those by 3 D-T2 FLAIR(61.5%)and by T1 WI(42.3%)respectively(all P<0.017),and the detection rate of abnormal cortical stracture by 3 D-T1 WI(69.2%)was obvionsly higher than that by T1 WI(26.9%)(P<0.017),but there was no significant difference in the detection rate of abnormal signal foci in white matter among the three sequences(P>0.05).There was no significant difference in the occurrence rate of different MRI signs in subtypes of FCD Ⅰ(all P>0.05).In axial,coronal and sagittal sections,3 D-T1 WI showed that the continuous layers of blurred gray-white matter junction were all≥3 layers,and the continuous layers of focal cortical structural abnormalities were all≥2 layers.Conclusion 3 D-T1 WI could improve the detection rate in children with FCD type I and can be used as the preferred MRI sequence.