脑性瘫痪的临床与MRI表现分析  

Clinical and magnetic resonance imaging features findings of cerebral palsy

作　　者：周陶成[1] 童光磊[1] 张敏[1] 李司南[1] 李红[1] 

机构地区：[1]安徽省立儿童医院康复科,安徽合肥230051

出　　处：《中国儿童保健杂志》2013年第2期170-173,共4页Chinese Journal of Child Health Care

摘　　要：【目的】探讨脑性瘫痪(脑瘫)患儿脑MRI的表现及其与脑瘫类型、出生胎龄、年龄、高危因素之间的关系。【方法】回顾性分析184例脑瘫患儿的临床与MRI表现。【结果】184例脑瘫患儿MRI异常率为88.6%,早产和足月儿组MRI异常率分别为95.9%和83.6%。痉挛型双瘫、四肢瘫、偏瘫、肌张力低下型、不随意运动型、共济失调型和混合型脑瘫MRI异常率分别为82.1%、100%、100%、80.6%、80.0%、100%和81.8%。各类型脑瘫的MRI异常表现不同:痉挛性四肢瘫的异常MRI表现广泛、弥漫的两侧脑损伤,痉挛性双瘫以脑室周围白质软化(periventricular leukomala-cia,PVL)为主(56.7%),不随意运动型多有基底节区病变(75%),共济失调型均有小脑发育不良,偏瘫型多为单侧脑损伤(90%)。不同出生胎龄的MRI特点不同,早产儿脑损伤以PVL多见(71.6%);足月儿脑损伤表现多样性且病变广泛。在不同年龄段中,1岁以内的患儿MRI异常率最高(93.6%),头颅MRI异常率随着年龄增长逐渐降低。高危因素中MRI异常率较高的依次是:出生低体重、早产、缺氧窒息。【结论】MRI影像改变与脑瘫类型、胎龄、年龄、高危因素密切相关。[Objective] To investigate the relationship between the brain MRI and cerebral palsy （CP） types,gestational age,age and risky factors. [Method] All the 184 hospitalized CP cases were examined neurologically and their perinatal history were reviewed. [Results] MRI abnormalities were found in 163 of the 184 cases and abnormal rates of spastic diplegia, t etraplegia, hemiplegia, athetosis, hypotonia, ataxia and mixed were 82.1%, 100 %,100 %, 80.0 %, 80.6 %, 100% and 81.8 %, respectively. Spastic tetraplegia was associated with extensive, bilateral, diffuse brain damage. 38 of 55 （69.1 %） children with spastic diplegia had significant periventricular leukomalacia（PVL）. Of the 20 children with hemiplegia, 18 had unilateral lesions on neuroimaging. In different age groups, children less than 1 year of age had the highest rate of MRI abnormalities （93.6 %）,brain MRI abnormality rate decreased gradually with age. Risky factors in the higher rate of MRI abnormalities were：low birth weight,prematurity and hypoxia asphyxia. [Conclusion] MRI changes are closely re- lated to CP types,gestational age,age and risky factors.

关 键 词：脑性瘫痪 磁共振成像 胎龄 年龄 高危因素 

分 类 号：R725[医药卫生—儿科]