生后不同时期诊断囊性脑室周围白质软化新生儿磁共振成像特点与运动发育结局  

Cystic periventricular leukomalacia： magnetic resonance imaging changes and motor development outcomes in neonates at different stages after birth

作　　者：曹方方[1] 富建华[1] 薛辛东[1] Cao Fangfang;Fu Jianhua;Xue Xindong(Department of Pediatrics,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院新生儿科,沈阳110004

出　　处：《中华新生儿科杂志（中英文）》2018年第4期271-276,共6页Chinese Journal of Neonatology

摘　　要：目的以磁共振成像（magnetic resonance imaging，MRI）资料为依据，对比新生儿生后不同阶段诊断囊性脑室周围白质软化（cystic periventricular leukomalacia，cPVL）的MRI特点，探讨其与运动发育结局的关系。方法选取2010年1月至2015年5月本院新生儿科经MRI确诊的cPVL患儿进行回顾性分析，根据确诊时间分为早期诊断组（≤7 d）和晚期诊断组（〉7 d），分析两组患儿cPVL的MRI特点，比较两组患儿门诊随访的运动发育结局。结果早期诊断组共35例，囊腔主要位于侧脑室前角（35例），其次为侧脑室体部（2例）和半卵圆中心（1例），囊腔数量单个17例，2个14例，3个及以上4例；晚期诊断组共45例，囊腔主要位于半卵圆中心（35例）和侧脑室后角（34例），其次为侧脑室体部（20例）和侧脑室前角（10例），囊腔数量单个3例，2个5例，3个及以上37例。早期诊断组共随访23例，22例肢体运动正常，1例出现痉挛性双瘫（4.3%）；晚期诊断组共随访24例，4例肢体运动正常，20例出现痉挛性偏瘫、双瘫或四肢瘫（83.3%），晚期诊断组脑性瘫痪发生率高于早期诊断组，差异有统计学意义（P〈0.05）。结论生后不同时期诊断cPVL患儿的MRI所示囊腔位置、数量均有不同，早期被证实存在cPVL的患儿运动发育结局较好，提示宫内发生的cPVL预后优于生后获得的cPVL。ObjectiveTo compare the magnetic resonance imagings （MRI） of neonates diagnosed with cystic periventricular leukomalacia （cPVL） at different stages after birth, and to clarify the relationship of MRI and motor development outcomes.MethodData of neonates admitted to the Shengjing Hospital of China Medical Univerisity from January 2010 to May 2015 diagnosed with cPVL by MRI were studied retrospectively. Subjects were assigned into two groups according to time of diagnosis： early-diagnosed group （≤7 d） and late-diagnosed group （〉7 d）. The MRI and subsequent motor development outcome were compared between two groups.ResultThere were 35 neonates in early-diagnosed group. The cysts were mainly located in the anterior horn of the lateral ventricle （35 infants）, the body of the lateral ventricle （2 infants） and the centrum semiovale （1 infants）. Only one cyst were found in 17 infants, two cysts in 14 infants, three or more cysts in 4 infants. There were 45 cases in the late-diagnosed group, the cysts were mainly located in the centrum semiovale （35 infants） and the posterior horn of the lateral ventricle （34 infants）, the body （20 infants） and the anterior horn （10 infants） of lateral ventricle. Only one cyst were found in 3 infants, two cysts in 5 infants, three or more cysts in 37 infants. Among the 23 infants in the early-diagnosed group with follow-up, 22 infants are clinically normal, one infant with spastic diplegia （4.3%）. Among the 24 infants in the late-diagnosed group with followe-up, 4 infants are clinically normal, 20 infants with spastic hemiplegia, diplegia or quadriplegia （83.3%）. There are significant differences of incidence of cerebral palsy between the two group （P〈0.05）.ConclusionMRI imaging showed that the location, number of cysts are different between the early-diagnosed and late-diagnosed group, and the motor development outcome of the early-diagnosed group are better, which indicates the prognosis of cPVL that occurred in utero are b

关 键 词：白质软化病 脑室周围 磁共振成像 囊性 运动发育结局 

分 类 号：R445.2[医药卫生—影像医学与核医学] R742[医药卫生—诊断学]