1060例脑性瘫痪患者MRI表现及其与临床特征的关系  

Relationship between magnetic resonance imaging and clinical characteristics of cerebral palsy based on 1060 cases

作　　者：王耸 程洪斌[2] 伊龙[2] 王培申 孙宪昶 安沂华 

机构地区：[1]锦州医科大学武警总医院研究生培养基地,北京100039 [2]中国人民武装警察部队总医院功能神经外科,北京100039 [3]中国人民武装警察部队总医院CT科,北京100039

出　　处：《山东大学学报（医学版）》2017年第12期36-42,共7页Journal of Shandong University:Health Sciences

摘　　要：目的探讨脑性瘫痪(脑瘫)患者的磁共振成像(MRI)表现及其与脑瘫类型、高危因素的关系。方法回顾性分析病历完整并最终确诊的1 060例脑瘫患者资料,包括基本信息、高危因素、MRI表现等。结果 1 060例患者中头颅MRI表现异常占82.17%,其中以脑室旁(或周围)白质软化症(PVL)(27.93%)、侧脑室扩大(13.11%)、脑萎缩(10.85%)、髓鞘发育不良(10.28%)及胼胝体发育不良(10.19%)等多见。痉挛型脑瘫患者M RI异常率为83.65%,其中以PVL、侧脑室扩大、髓鞘发育不良多见;不随意运动型患者M RI异常率为60.98%,其中以基底节异常信号、PVL、侧脑室扩大多见;共济失调型脑瘫患者MRI异常率为88.57%,其中以小脑发育不良、胼胝体发育不良、PVL多见;混合型脑瘫患者MRI异常率为75.90%。PVL、侧脑室扩大、脑裂畸形在早产患者中比例较高且差异有统计学意义(P均<0.05);PVL、髓鞘发育不良、局灶性脑缺血在具有缺氧因素患者中比例较高且差异有统计学意义(P均<0.05);基底节异常信号、局灶性脑缺血在具有黄疸因素患者中比例较高且差异有统计学意义(P均<0.05)。结论 MRI检查是脑瘫患儿的首选辅助检查方法,其结果与患者脑部病变及脑瘫的类型、高危因素密切相关。Objective To analyze the relationship between the brain magnetic resonance imaging（ MRI） and cerebral palsy types/risk factors. Methods Information,including age,risk factors,clinical classification and MRI findings,of 1 060 hospitalized patients with cerebral palsy was reviewed. Results Among the 1 060 patients,the abnormal rate of brain MRI results was 82. 17%,in which periventricular leukomalacia（ PVL）（ 27. 93%）,enlargement of the lateral ventricles（ 13. 11%）,brain atrophy（ 10. 85%）,delayed myelination（ 10. 28%）,and abnormal corpus callosum（ 10. 19%） were the common types. The abnormal rate of spastic cerebral palsy was 83. 65%,in which PVL,enlargement of the lateral ventricles,and delayed myelination were the commen types. The abnormal rate of dyskinetic cerebral palsy was 60. 98%,in which basal ganglia damage,PVL and enlargement of the lateral ventricles were the common types. The abnormal rate of ataxic cerebral palsy was 88. 57%,in which cerebellar hypoplasia and abnormal corpus callosum were the common types. The abnormal rate of mixed type was 75. 90%. Proportions of PVL,enlargement of the lateral ventricles and schizencephaly were higher in prematurity patients（ all P〈0. 05）. Proportions of PVL,delayed myelina-tion,and focal cerebral ischemia were higher in patients with hypoxia asphyxia（ all P〈0. 05）. Proportions of basal ganglia damage and focal cerebral ischemia were higher in patients with pathologic jaundice（ both P〈0. 05）. Conclusion MRI has important clinical significance in children with cerebral palsy and its changes are closely related to cerebral palsy types and risk factors.

关 键 词：脑性瘫患 磁共振成像 高危因素 

分 类 号：R741[医药卫生—神经病学与精神病学]