基于高分辨MRI对Ⅰ、Ⅱ型局灶性皮质发育不良患儿的手术预后分析  

Surgical prognosis analysis of children with focal cortical dysplasia of typeⅠandⅡbased on high-resolution MRI

作　　者：李林 李方元 崔若棣 赵建设 孙志群[3] LI Lin;LI Fangyuan;CUI Ruodi;ZHAO Jianshe;SUN Zhiqun(Department of Medical Imaging,Qilu Children's Hospital of Shandong University,Ji'nan 250022,China;Department of Medical Imaging,Ji'nan Southern Suburb Hospital,Ji'nan 250000,China;Department of Neonatology,Weifang People's Hospital,Weifang,Shandong Province 261071,China)

机构地区：[1]山东大学齐鲁儿童医院医学影像科,山东济南250022 [2]济南南郊医院医学影像科,山东济南250000 [3]潍坊市人民医院新生儿科,山东潍坊261071

出　　处：《实用放射学杂志》2022年第7期1154-1157,共4页Journal of Practical Radiology

基　　金：济南市卫生和计划生育委员会科技计划项目(2018-01-31)。

摘　　要：目的探讨Ⅰ、Ⅱ型局灶性皮质发育不良(FCD)患儿高分辨MRI征象及预后。方法回顾性分析经病理证实47例FCD患儿MRI及临床资料。比较高分辨MRI与常规序列对各种征象检出率差异,对照病灶MRI区域与致痫范围关系,分析诸因素(手术方式、FCD类型、致痫部位)对手术预后的影响。结果高分辨MRI对灰白质分界模糊、皮质结构异常及灰白质内异常信号检出率高于常规序列(P<0.05)。41例(87.2%)致痫范围大于病灶MRI区域。致痫灶全部切除患儿预后好于局部切除者、Ⅰ型好于Ⅱ型、低年龄组好于高年龄组、颞叶癫痫好于其他部位(P<0.05)。致痫灶切除方式是影响患儿手术预后的独立因子。结论儿童FCD具有灰白质分界模糊伴其内异常信号、皮质结构异常及transmantle征等特异征象,高分辨MRI能够提高上述征象检出率,为首选序列。致痫灶完全切除是手术成功关键。Objective To explore the high-resolution MRI signs and prognosis of children with focal cortical dysplasia(FCD)of typesⅠandⅡ.Methods The MRI and clinical data of 47 children with FCD confirmed by pathology were analyzed retrospectively.The difference in the detection rate of various signs between high-resolution MRI and conventional sequences was compared,the relationship between the MRI area of the lesion and the extent of epilepsy was compared,and the influence of various factors(operation method,FCD type,epileptic location)on the prognosis of surgery was analyzed.Results The detection rate of blurring of graywhite matter boundaries,abnormal cortical structure,and abnormal signals in gray and white matter in high-resolution MRI was higher than that of conventional sequences(P<0.05).In 41 cases(87.2%),the epileptic range was larger than the MRI area of the lesion.Children with all epileptic foci removed had a better prognosis than those with partial resection;typeⅠwas better than typeⅡ,the younger age group was better than the older age group;and the temporal lobe epilepsy was better than other parts(P<0.05).The resection of epileptic foci was an independent factor that affects the prognosis of children with surgery.Conclusion FCD in children have characteristic MRI signs,such as blurring of gray-white matter boundaries with abnormal internal signal,abnormal cortical structure and transmantle sign,high-resolution MRI can improve the detection rate of the above signs,and is the first choice for examination sequence.Complete excision of epileptic foci is thekey to a successful operation.

关 键 词：儿童 局灶性皮质发育不良 高分辨磁共振成像 预后 

分 类 号：R742[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学] R651.11