磁共振动脉自旋标记技术评价痉挛性单侧脑瘫患儿颈总动脉交感神经网剥落术前后脑血流量的变化研究  

Study on the MR ASL in evaluating the change of cerebral blood flow before and after the surgery of common carotid sympathetic nerve net stripping of children with spastic unilateral cerebral palsy

作　　者：宋娟 聂聪科[2] 韩秉艳 王禄伟[2] SONGJuan;NIE Cong-ke;HAN Bing-yan(Department of Medical Image,The Seventh Affiliated Hospital of Xinjiang Medical University,Urumqi 830028,China;不详)

机构地区：[1]新疆医科大学第七附属医院医学影像科,新疆乌鲁木齐830028 [2]新疆医科大学第二附属医院医学影像科,新疆乌鲁木齐830000

出　　处：《中国医学装备》2021年第7期54-57,共4页China Medical Equipment

基　　金：新疆自治区自然科学基金(2019D01C233)“MR-pCASL技术评价脑瘫患儿颈总动脉交感神经网剥脱术后脑血流量改变的应用研究”。

摘　　要：目的:探究磁共振动脉自旋标记(ASL)技术对痉挛性单侧脑瘫患儿行颈总动脉交感神经网剥脱术前后脑血流量(CBF)的变化,以及对术后疗效和运动功能的影响。方法:选取医院收治的66例痉挛性单侧脑瘫患儿,分别于术前、术后进行双侧大脑半球常规序列以及扩散加权成像(DWI)、ASL序列进行扫描,应用后处理工作站软件获得患儿双侧颞叶、双侧额叶、双侧顶叶、基底节区、丘脑区和小脑区的CBF值,对比分析治疗前后运动功能量表(GMFM)评分以及Ashworth痉挛评定量表分级情况。结果:术前患侧与健侧CBF相比颞叶、顶叶、额叶、基底节区和丘脑区CBF降低,差异有统计学意义(t=7.794,t=6.251,t=11.384,t=6.860,t=5.584;P<0.01);术后患侧颞叶、额叶、基底节区及顶叶较术前患侧CBF有改善,差异有统计学差异(t=7.665,t=4.912,t=15.500,t=3.464;P<0.01);小脑区、丘脑区CBF差异无统计学意义(t=2.012,t=0.342;P>0.05);术后与术前GMFM评分比较均有明显的好转,差异有统计学差异(t=11.320,P<0.01),且Ashworth痉挛分级有明显的好转(Z=3.341,P<0.05)。结论:磁共振ASL技术用于颈总动脉交感神经网剥脱术治疗痉挛性单侧脑瘫患儿疗效显著,可以改善临床症状,且提高患儿脑部CBF。Objective:To explore the changes of cerebral blood flow(CBF)before and after the surgery of common carotid sympathetic nerve network stripping in children with spastic unilateral cerebral palsy by using the technique of artery spin labeling(ASL),and to evaluate the effect of that on postoperative treatment and motor function.Methods:66 children with spastic unilateral cerebral palsy were selected,and they were scanned with routine sequence,diffusion weighted imaging(DWI)and ASL sequence on bilateral cerebral hemispheres before and after surgery,respectively.And the post process workstation software was applied to obtain the CBF values of bilateral temporal lobe,bilateral frontal lobe,bilateral parietal lobe,basal ganglia region,thalamus region and cerebellum region.And the score of gross motor function measure(GMFM)and grading results of Ashworth spasm rating scale between before and after treatment were compared and analyzed.Results:The CBF values in temporal lobe,parietal lobe,frontal lobe,basal ganglia region and thalamus of the affected side were significantly lower than those of the healthy side before surgery(t=7.794,t=6.251,t=11.384,t=6.860,t=5.584,P<0.01).And compared with those before surgery,the CBF values in temporal lobe,frontal lobe,basal ganglia region and parietal lobe of the affected side were improved after surgery(t=7.665,t=4.912,t=15.500,t=3.464,P<0.01).There were no significant difference in CBF of cerebellum region and thalamus region between them(t=2.012,t=0.342,P>0.05).Compared with that pre operation,the GMFM score post operation was significantly improved(t=11.320,P<0.01).At the same time,Ashworth spasm grading also was improved significantly(Z=3.341,P<0.05).Conclusion:Magnetic resonance(MR)ASL has significantly curative effect on common carotid sympathetic nerve net stripping of children with spastic unilateral cerebral palsy,which can improve the clinical symptoms and enhance brain CBF of children.

关 键 词：磁共振(MR) 动脉自旋标记(ASL)技术 脑瘫 颈动脉交感神经网剥脱术 

分 类 号：R445.2[医药卫生—影像医学与核医学]