DTI对有中枢神经系统相关症状但常规MR阴性儿童脑白质病变的诊断价值  

Diagnostic value of DTI in cerebral white matter lesions in children with central nerve system symptom but without abnormal common MR study

作　　者：余庆华[1] 邹松[2] 

机构地区：[1]福建医科大学省立临床医学院放射科,福建福州350012 [2]福建医科大学附属协和医院CT/MR室,福建福州350012

出　　处：《医学影像学杂志》2015年第1期10-13,26,共5页Journal of Medical Imaging

摘　　要：目的探讨DTI对有中枢神经系统相关症状但常规MR阴性儿童脑白质病变的诊断价值。方法收集我院临床高度怀疑有中枢神经系统病变但常规MRI阴性的56例患儿及50例正常儿童做对照组进行DTI检查,与对照组比较患儿组病变区内DTI的四个参数值;并且评估DTI四个参数图对病变的发现能力。运用spss13.0软件进行相应统计处理。结果 56例患儿组在FA图上发现病变有38例,RA图上36例,1-VR图上30例,ADC图上23例。病变主要位于侧脑室旁的额叶和顶叶白质区,较对照组感兴趣区内RA、FA、1-VR均值均有显著差异,在顶叶区ADC值两组间有显著差异,而在额叶区无统计学差异。纤维束跟踪显示病灶区纤维数目变少,连续性欠佳或变短、变小。FA、RA图对病变的发现能力高于ADC图,而FA、RA、1-VR图三者差别无统计学意义,P=?。结论 DTI能够敏感发现儿童脑白质病变,临床上对于怀疑有中枢神经病变但常规MRI阴性患儿应建议进一步行DTI检查。Objective To study the value of DTI in diagnosis of cerebral white matter lesions in children with central nerve system symptom but without abnormal common MR study. Methods 56 cases of children, who were highly suspected with central nerve system lesions in clinic but without abnormal common MR study, and 50 cases of normal children as control group were under DTI examinations. Four DTI parameters of ROI in lesions was compared to control group respec- tively. The sensitivity of each DTI parameter map in detection of lesions were also investigated. All statistic analysis was conducted on SPSS 13.0 software. Results Cerebral white matter lesions were found in 38 cases on FA map, and 36 cases, 30 cases, and 23 cases were found on RA, 1-VR, ADC maps, respectively. Lesions predominantly located frontal lobe and parietal lobe white matter closing to lateral ventricle. FA, RA, and 1-VR of ROI in lesions were found statistic significant difference when compared control group. Compared with control group, the statistic significant difference of ADC was found in parietal lobe, but not in frontal lobe. By using three-dimensional fiber tracking technology, fibers in ROIs of lesions were presented a decrease in number, poor in continuity, shorter or smaller than control group. The sensi- tivity of FA, RA map in detection of lesions were better than ADC map, while, no significant difference was found about the sensitivity of FA, RA, 1-VR map in detection of lesions. Conclusion DTI sequence could sensitively detect white matter lesions in children. Children, who were suspected with central nerve system lesions in clinic but without abnormal common MR study, were suggested to further DTI study.

关 键 词：儿童 脑白质病变 纤维束 弥散张量成像 磁共振成像 

分 类 号：R748[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]