婴幼儿脑发育及外部性脑积水的MRI研究分析  

The Study of MRI in Brain Development and External Hydrocephalus of Neonates and Infants

作　　者：张雷[1] 任转勤 陈涛[1] 王晓虎[1] 霍敏华[1] 王晓强[1] 李静[1] 李莉[1] 任慧鹏[1] 苟晓光 

机构地区：[1]宝鸡市中心医院影像科,陕西宝鸡721008

出　　处：《华西医学》2014年第10期1895-1899,共5页West China Medical Journal

基　　金：陕西省社会发展攻关计划(2010K15-06-04)~~

摘　　要：目的揭示发育期婴幼儿脑室及脑外间隙随月龄变化的特征,并探讨外部性脑积水MRI诊断标准。方法选取2009年1月-2013年5月就诊宝鸡市中心医院疑诊脑部疾患小儿,经严格纳入和排除标准选择671例3岁以内没有神经系统疾病的婴幼儿,按月龄分为9组,在T1WI上测量脑室大小,即前角指数、体部指数,计算脑室颅腔横径（VT/ST）比值,在T2WI上测量脑外间隙、前纵裂、外侧裂的宽度;149例外部性脑积水患儿,采用上述相同的测量方法,并动态观察外部性脑积水的变化。结果 1脑室体积随年龄增长而增大,但其前角指数[（0.32±0.05）mm]及VT/ST比值（14.09%±1.56%）较恒定;脑外间隙随年龄增长呈先增宽后变窄的趋势,〉3～6月龄组为这种趋势的转折点。2外部性脑积水患儿额部蛛网膜下腔、前纵裂及外侧裂间隙均超过相应年龄组标准值上限,VT/ST比值〈15%。结论婴幼儿脑室及脑外间隙各年龄组标准值为评价小儿脑发育提供依据,其中前角指数和VT/ST比值是判定脑室大小的可靠指标;蛛网膜下腔和半球间裂宽度及VT/ST比值可作为诊断外部性脑积水的客观指标。对于继发性外部性脑积水,应采取积极临床干预。Objective To measure the ventricular size and extracerebral space of normal neonates and infants, and discuss the diagnostic criteria of MRI in external hydrocephalus. Methods Neonates and infants suspected to have brain diseases treated in our hospital from January 2009 to January 2013 were selected, and through strict inclusion and exclusion, 671 neonates and infants within 3 years of age and without neural system disease were included in our study. They were divided into 9 age groups. The ventricular size was measured on T1 WI, that was bifrontal index, bibody index and the ratio of ventricle and cranial cavity diameter（VT/ST）. And the width of extracerebral space, intercerebral fi ssure and sylvian fi ssure were measured on T2 WI. A total of 149 neonates and infants with external hydrocephalus underwent the same measurement, and the changes in external hydrocephalus were dynamically observed. Results Ventricular volume increased gradually with age, but the bifrontal index [（0.32 ± 0.05） mm] and the ratio of VT/ST（14.09% ± 1.56%） were relatively constant. The extracerebral space widened with age during 0-6 months, after which it began to narrow, and the age of 3-6 months was the turning point for this trend. The frontal subarachnoid, intercerebral fi ssure, and sylvian fi ssure of infants with external hydrocephalus were wider than standard values of the corresponding age group, and the ratio of VT/ST was less than 15%. Conclusions The standard values of ventricular size and extracerebral space of each age group provide the basis for the evaluation of brain development. Among them, the bifrontal index and the ratio of VT/ST are reliable indicators to determine the ventricular size. Subarachnoid depth, intercerebral fi ssure, and the ratio of VT/ST play an important role in the diagnosis of EH. But for secondary external hydrocephalus, early treatment should be carried out.

关 键 词：婴幼儿 脑外间隙 外部性脑积水 磁共振成像 

分 类 号：R726.5[医药卫生—儿科]