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目的应用磁共振扩散成像技术探讨儿童皮质脊髓束年龄和性别差异及其变化规律。方法 90例无中枢神经系统症状及体征且颅脑磁共振检查正常的儿童(年龄5d~18岁)。按年龄分为5组:婴儿组(组1,≤1岁),幼儿组(组2,>1~3岁),学龄前组(组3,>3~6岁),学龄组(组4,>6~12岁),青春发育期组(组5,>12~18岁)。每个年龄组内再按性别分为男、女2组。各组儿童分别行头部扩散张量成像,根据感兴趣法选取皮质脊髓束感兴趣区并重建,测量重建的皮质脊髓束的扩散张量参数并进行统计学分析。结果各年龄组的表观扩散系数(ADC)值、分数各向异性(FA)值、纤维示踪平均长度、体积以及示踪的纤维束数量不完全相同(P<0.01);组间的两两比较间发现,1组与2组间ADC值、FA值及示踪纤维平均长度差异具有统计学意义;2组与3组间FA值差异具有统计学意义;3组与4组间ADC值、FA值、示踪纤维平均长度、纤维束数目及体积差异均具有统计学意义。ADC值与年龄间呈负相关,余参数与年龄间呈正相关。结论儿童皮质脊髓束发育具有阶段性,且具有阶段性特征;磁共振扩散张量技术可用于观测儿童皮质脊髓束,评价其发育状况。
Objective To investigate the differences of age and gender in children with corticospinal tract and its variation by using magnetic resonance diffusion imaging. Methods Ninety children without central nervous system symptoms and signs who had normal brain magnetic resonance imaging (aged 5 to 18 years) were enrolled. They were divided into five groups according to their ages: infants (group 1, ≤1 year old), infants (group 2,> 1-3 years old), preschool group (group 3,> 3-6 years old), school age group ,> 6 ~ 12 years old), pubertal group (group 5,> 12 ~ 18 years old). Divided into male and female in each age group by gender. Each group of children underwent diffusion tensor imaging of the head. According to the method of interest, the region of interest of the corticospinal tract was selected and reconstructed. The diffusion tensor parameters of the reconstructed corticospinal tract were measured and statistically analyzed. Results The ADC value, fractional anisotropy (FA) value, average length of fiber tracer, volume and number of tracer fiber bundles in each age group were not all the same (P <0.01) Between the two comparisons, ADC value, FA value and average length of tracer fiber in group 1 and group 2 were statistically significant. There was significant difference in FA between group 2 and group 3, ADC value between group 3 and group 4 , FA value, mean length of tracer fiber, number of fiber bundles and volume difference were all statistically significant. ADC value was negatively correlated with age, the remaining parameters were positively correlated with age. Conclusions The development of corticospinal tract in children has stage and stage features. The diffusion tensor technique can be used to observe the corticospinal tract of children and evaluate its development.