痉挛性脑性瘫痪早产儿脑CT图像表现及其鉴别诊断价值  

CT Image Manifestations of Premature Infants with Spastic Cerebral Palsy and the Differential Diagnosis Value

作　　者：孙常华[1] 康莺歌 张利敏[1] 赵晓卫[1] 张原景 SUN Chang-hua;KANG Ying-ge;ZHANG Li-min;ZHAO Xiao-wei;ZHANG Yuan-jing(Department of Neonatology,the Seventh People's Hospital of Zhengzhou,Zhengzhou 455000,Henan Province,China)

机构地区：[1]郑州市第七人民医院新生儿科,河南郑州455000

出　　处：《中国CT和MRI杂志》2022年第8期28-30,共3页Chinese Journal of CT and MRI

摘　　要：目的分析痉挛性脑性瘫痪早产儿脑CT图像表现及其CT对痉挛性脑性瘫痪的鉴别诊断价值。方法按纳入与排除标准选取39例2013年1月至2019年7月本院收治的小儿痉挛性脑瘫患儿作为病例组,另按年龄匹配原则选取同期在本院儿科就诊的30例儿童作为对照组;分析痉挛性脑瘫患儿的CT图像表现,绘制受试者工作特征(ROC)曲线分析脑CT图像表现对痉挛性脑瘫的诊断价值。结果39例痉挛性脑瘫患儿中,82.50%的患儿CT影像学表现为脑室周围白质成角,左右角度不对称,74.36%的患儿CT影像学表现为脑室扩大变形或(和)白质丧失,61.54%的患儿CT影像学表现为灰质异常增多则聚集成团,左右不对称;其中脑室周围白质成角,左右角度不对称征象诊断痉挛性脑瘫的曲线下面积值(AUC)值最高,为0.910,敏感度、特异度分别为82.05%、100.00%;按痉挛性脑瘫患儿CT征象出现频次,选取上述位于前三位的征象联合诊断痉挛性脑瘫,结果显示联合诊断的AUC值为0.962,敏感度、特异度分别为92.31%、100.00%,显著高于脑室周围白质成角,左右角度不对称征象诊断(Z=2.084,P=0.037)。结论痉挛性脑性瘫痪早产儿脑CT图像表现存在一定特征,并可作为诊断早产儿痉挛性脑瘫的敏感征象,值得临床重视。Objective To analyze the CT image manifestations of premature infants with spastic cerebral palsy and the value of CT in the differential diagnosis of spastic cerebral palsy.Methods According to the inclusion and exclusion criteria,39 children with spastic cerebral palsy admitted to the hospital between January 2013 and July 2019 were selected as the case group.30 children of matching age treated in the department of pediatrics of the hospital during the same period were selected as the control group.The CT image manifestations of children with spastic cerebral palsy were analyzed.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of brain CT image manifestations for spastic cerebral palsy.Results CT image manifestations of 82.50%of the 39 children with spastic cerebral palsy showed periventricular white matter forming an angle,and the left and right angles were asymmetrical.CT image manifestations of 74.36%showed ventricular enlargement and deformation or(and)white matter loss.CT image manifestations of 61.54%showed abnormally increased gray matter in cluster shape,with left-right asymmetry.Among the signs,the area under the curve(AUC)of periventricular white matter forming an angle and asymmetrical left and right angles for the diagnosis of spastic cerebral palsy was the largest(0.910).The sensitivity and specificity were 82.05%and 100.00%respectively.According to the frequency of CT signs in children with spastic cerebral palsy,the AUC of combined diagnosis of the top three signs was 0.962.The sensitivity and specificity were 92.31%and 100.00%,respectively,which were significantly higher than those of periventricular white matter forming an angle and asymmetrical left and right angles(Z=2.084,P=0.037).Conclusion The CT image manifestations of premature infants with spastic cerebral palsy are characteristic.They can be used as sensitive signs for diagnosing spastic cerebral palsy in preterm infants.

关 键 词：痉挛性脑性瘫痪 早产儿 脑CT图像表现 鉴别诊断价值 

分 类 号：R445.3[医药卫生—影像医学与核医学] R742.3[医药卫生—诊断学]