单光子发射型计算机体层摄影术脑血流灌注显像在脑性瘫痪患儿运动障碍中的意义  

Clinical Significance of Single Photon Emission Computed Tomography Regional Cerebral Blood Flow Imaging on Dyskinesia in Children with Cerebral Palsy

作　　者：唐亮[1] 王子才[2] 

机构地区：[1]上海交通大学附属儿童医院康复中心,上海200040 [2]上海交通大学附属第六人民医院儿科,上海200233

出　　处：《实用儿科临床杂志》2008年第18期1452-1453,1469,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的了解脑性瘫痪(CP)患儿是否存在局部脑血流异常,以及这种异常与病变部位和临床表现的关系。方法对30例痉挛型四肢瘫或偏瘫CP患儿进行头颅单光子发射型计算机体层摄影术(SPECT)脑血流灌注显像检查,结合临床表现,研究其头颅SPECT的脑血流灌注异常与脑损伤病变部位和临床表现的关系。结果30例CP患儿中头颅SPECT异常者28例。其中双侧大脑弥散性放射性减低6例,大脑局限性放射性减低22例。四肢瘫患儿头颅SPECT典型表现为双侧大脑顶叶放射性减低,以下依次为额叶、基底核、颞叶和枕叶。偏瘫患儿头颅SPECT典型表现为患肢对侧大脑顶叶放射性减低,以下依次为患肢对侧额叶、颞叶和基底核;四肢瘫患儿左右两侧病变部位构成无统计学差异(P>0.05),左偏瘫患儿左右两侧顶叶病变例数差异有统计学意义(P<0.05);四肢瘫、偏瘫的顶叶与额叶比较病变概率增加(Pa<0.05)。结论CP患儿存在相应部位脑供血方面异常,头颅SPECT的脑血流灌注异常与脑损伤病变部位和临床表现之间有一定关系。Objective To understand whether there is abnormality of regional cerebral blood flow （rCBF） and to research the correlation between clinical status,lesion location and rCBF. Methods Thirty children with cerebral palsy （CP） were tested by single photon emission computed tomography （SPECT） rCBF. In correlation with clinical analysis, the relativity between abnormality of rCBF and lesion location was analyzed. Results Twenty - eight cases showed abnormal SPECT. It showed that brain cortex single focus or multiple foci which were either local or diffuse. Six of the patients showed that impaired brain areas were diffuse, 22 cases were local. In spastic quadriplegic, the most impaired brain areas were in bilateral parietal lobe, that some of them were in frontal lobe, temporal lobe, occipital lobe and basal nuclei. In spastic hemiplegia, the most impaired brain areas were in contralateral parietal lobe, that some of them were in contralateral frontal lobe, temporal lobe and basal nuclei. Compared with abnormality of rCBF both in right and left lobes of cerebrum in spastic quadriplegic, there was no significant difference between them（ P 〉 0.05 ）. Compared with abnormality of rCBF in spastic left hemiplegia, there was significant difference between right and left lobes of cerebrum（ P 〈 0. 05 ）. The abnormality of rCBF in parietal lobe was significantly higher than that in frontal lobe （Pa 〈0.05 ）. Conclusions There exists abnormality of rCBF in children with CP. In correlation with clinical analysis, some relationships between the abnormality of rCBF and lesion location were very distinctive.

关 键 词：脑性瘫痪 局部脑血流 单光子发射型计算机体层摄影术 

分 类 号：R742.3[医药卫生—神经病学与精神病学]