论文部分内容阅读
目的:探讨磁共振扩散张量成像(DTI)及白质纤维束成像(FT)技术对评价偏瘫型脑性瘫痪患儿皮质脊髓束损伤的临床应用价值。方法:选取12例临床确诊为偏瘫型脑性瘫痪患儿和12例年龄匹配的健康婴幼儿进行常规MRI和DTI检查,重建皮质脊髓束图,采用Peabody运动发育量表总运动商(TMQ)对患儿运动功能进行评分,按轻、中、重度功能障碍对患儿进行分组。分析大脑脚、内囊后肢、放射冠及半卵圆中心的部分各向异性值(FA),计算左右两侧皮质脊髓束FA值的不对称差异度(△FA)并进行统计学分析。结果;纤维束成像图显示偏瘫患侧皮质脊髓束稀疏、受压变形、移位和部分中断;配对资料t检验显示偏瘫组患侧各兴趣区FA值均较健侧对应部位显著减低(P<0.01)。偏瘫组各部位△FA与正常对照组比较差异有统计学意义(P<0.05),Pearson相关分析显示皮质脊髓束两侧的△FA均数与总运动商(TMQ)评分呈负相关(r=-0.764,P=0.004)。患侧皮质脊髓束在示踪图上的损伤分级与总运动商(TMQ)分组间具有相关性(χ2=6.942,P=0.018)。结论:扩散张量成像和白质纤维束成像在评价偏瘫型脑性瘫痪患儿脑内皮质脊髓束的变化方面有较高的应用价值。
Objective: To investigate the clinical value of magnetic resonance diffusion tensor imaging (DTI) and white matter fiber bundle imaging (FT) in the evaluation of corticospinal tract injury in children with hemiparalyzed cerebral palsy. Methods: Twelve clinically diagnosed children with hemiparesis-type cerebral palsy and 12 age-matched healthy infants were selected for routine MRI and DTI examinations. The corticospinal tracts were reconstructed. Peabody TMD Children with motor function score, according to light, moderate and severe dysfunction groups of children. The anisotropy values (FA) of the cerebral peduncle, the inner hindlimbs, the radiant crowns and the centrum semiovale were analyzed. The asymmetry difference (FA) between the left and right cortical spinal cord FA values was calculated and statistically analyzed. Results: The fiber bundle imaging showed that the corticospinal tract of spina bifida was sparse, distorted, displaced and partially disrupted. The paired t-test showed that the FA values of all interested regions in the affected side of hemiparesis group were significantly lower than those of the contralateral counterparts (P < 0.01). The △ FA of hemiplegia group was significantly different from that of the normal control group (P <0.05). Pearson correlation analysis showed that the △ FA mean of both sides of corticospinal tract was negatively correlated with TMQ score (r = -0.764, P = 0.004). The lesion grade of the ipsilateral corticospinal tract on the tracer was correlated with the total movement quotient (TMQ) group (χ2 = 6.942, P = 0.018). CONCLUSION: Diffusion tensor imaging and white matter fiber bundle imaging are of high value in the evaluation of cerebral corticospinal tract changes in children with hemiparetic cerebral palsy.