磁共振扩散张量成像/扩散张量纤维束示踪成像(DTI/DTT)对小儿脑瘫早期诊断及康复评价的临床意义  

Diffusion tensor imaging / Fiber tractography (DTI / FT) in the assessment of early diagnosis and clinical significance in children with cerebral Palsy

作　　者：张晓凡 范国光[2] 王志伟 张旭 曾立红 张毅 王芳 

机构地区：[1]黑龙江哈尔滨儿童医院影像科 [2]中国医科大学第一临床医院

出　　处：《中国CT和MRI杂志》2011年第2期1-6,F0003,共7页Chinese Journal of CT and MRI

基　　金：哈尔滨市优秀学科带头人基金项目(编号:2010RFXQS025)

摘　　要：目的旨在探讨扩散张量成像(DTI)和纤维束示踪成像(FT)对小儿脑瘫早期诊断意义。方法选取1月-3岁临床初诊为脑瘫300例患儿为研究组,与研究组年龄及例数相匹配的正常小儿为对照组,行颅脑MRI和DTI检查。分1-6月,6月以上-1岁,1岁以上-3岁三段。测量研究组与正常组各兴趣区同部位白质纤维束的FA值,组间行多变量方差分析。分析各兴趣区纤维束的形态、数量及走向。90例康复治疗1年后随访。结果 1、研究组1-6月ICPL、GCC、SCC、AF、L-CG、PTR、R-ICAL,6月以上-1岁CC、L-ICPL、CR、GCC、SCC、L-SLF、R-AF,1岁以上-3岁CC、L-CST、R-CG兴趣区的平均FA值较正常组显著降低(P<0.05)。2、研究组256例(85.33%)PVL可识别兴趣区白质纤维束不同程度稀疏、缺失及走向异常;44例接近正常但对应平均FA值有轻度减低。3、90例随访患儿78例兴趣区FA值有不同程度增高,69例纤维束不同程度增多和走方改善,21例纤维束变化不明显。结论 DTI有助于临床对小儿脑瘫做出早期诊断,定期随访DTI对康复疗效可做出客观影像学评价。Objective To discuss diffusion tensor imaging （DTI） and Fiber tractography（FT）in assessment of early diagnosis and clinical significance in children with cerebral palsy. Methods 300 children suffered from cerebral palsy and 300 age-matched normal controls were recruited,All children were examined by conventional MRI and DTI. Age ranged from 1 month to 3 years were divided into three sections：1m-6m,6m-1y,1y-3y.FA values of ROIS in the same location were measured,FA values on diffusion tensor color maps were compared between the patients and the controls. All FA values were analyzed by multivariate analysis of variance. To analysis the shape,number and of tracts. 90 patients were followed up after 1 year. Results 1.The averaged FA values of study group is lower than control group,the difference was statistically significant（ P0. 05）. Patients from 1 month to 6 month are ICPL,GCC,SCC,AF,L-CG,PTR,R-ICAL.At least 6 months to 1 years are CC,L-ICPL,CR,GCC,SCC,L-SLF,R-AF,more than 1 years are CC,L-CST,R-CG showed a significant mean FA reduction （ P 0. 05）.2.In study group,identifiable fiber tracts of 256 cases accounting for 85.33% injuried in different degrees.Fiber tracts of 44 cases closed to normal.But the corresponding FA values reduced. 3.After 1 year,90 patients were followed up.FA values of 78 cases are relatively higher than before , fiber tracts are increased and the traveling direction improved in 69 cases,fiber tracts have no significantly improved in 21 cases. Conclusion DTI help clinicians to make accurate and early diagnosis for the children with cerebral palsy. Regular follow-up of cerebral palsy can make an objective evaluation of image.

关 键 词：磁共振扩散张量成像 部分各向异性 小儿 脑室旁白质软化 康复评价 

分 类 号：R445.2[医药卫生—影像医学与核医学] R748[医药卫生—诊断学]