脑性瘫痪和智力障碍儿童头颅MRI特征探讨  

Study on Cranial MRI Characteristics of Children with Cerebral Palsy and Intellectual Disability

作　　者：马德有[1] 袁俊英[1] 张小安[1] 孙二亮[1] MA Deyou;YUAN Junying;ZHANG Xiaoan(Department of Rehabilitation Medicine,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan Province 450000,P.R.China)

机构地区：[1]郑州大学第三附属医院康复医学科,450000

出　　处：《临床放射学杂志》2023年第9期1502-1506,共5页Journal of Clinical Radiology

基　　金：国家自然科学基金资助项目(编号:81870983)。

摘　　要：目的 探讨脑性瘫痪和智力障碍儿童头颅MRI特征的差异表现。方法 以诊断为依据,回顾性纳入符合标准的1076例脑性瘫痪和796例智力障碍患儿的头颅MRI,分析脑性瘫痪与智力障碍两个病种之间头颅MRI的异常率,以及分别与GMFCS分级和智力分度之间的关系。结果 脑性瘫痪与智力障碍儿童头颅MRI异常率比较,χ^(2)=543.692,P<0.001,两者差异有统计学意义;脑性瘫痪儿童头颅MRI异常率与GMFCS分级有趋势关系,χ^(2)=181.88,P<0.0001,头颅MRI异常率随着GMFCS分级增高而增高,Ⅳ级和Ⅴ级比较(χ^(2)=0.414,P=0.52>0.05),两者之间差异无统计学意义,可能与脑性瘫痪发病机制有关;智力障碍儿童头颅MRI异常率与智力障碍分度无关:χ^(2)=1.536,P=0.214>0.05;脑性瘫痪头颅MRI中异常表现最常见的是脑室周围软化最为多见(468例),占52.71%;其次为多发软化及萎缩(178例),占21.76%;智力障碍头颅MRI异常的各种表现中,以脑白质髓鞘化异常最为多见(67例),占41.88%;其次为脑外间隙增宽和脑室增大(38例),占23.75%。结论 头颅MRI检查对脑性瘫痪儿童具有推测病理机制、预测预后具有重要价值,比智力障碍儿童有更重要的意义。Objective To investigate the differences in brain MRI features of children with cerebral palsy and mental retardation.Methods Based on the diagnosis,1076 patients with cerebral palsy and 796 patients with mental retardation who met the criteria were retrospectively included.To analyze the abnormal rate of brain MRI between cerebral palsy and mental retardation,and the relationship with GMFCS classification and intelligence scale respectively.Results There was a statistically significant difference in the abnormal rate of brain MRI between children with cerebral palsy and mental retar⁃dation(χ^(2)=543.692,P<0.001).The abnormal rate of brain MRI in children with cerebral palsy had a trend relationship with the GMFCS grade(χ^(2)=181.88,P<0.0001).The abnormal rate of head MRI increased with the increase of GMFCS grade.There was no statistical difference between grade IV and grade V(χ^(2)=0.414,P=0.52>0.05),which may be re⁃lated to the pathogenesis of cerebral palsy.The abnormal rate of brain MRI in children with mental retardation was not relat⁃ed to the degree of mental retardation(χ^(2)=1.536,P=0.214>0.05).The most common abnormality in brain MRI of cer⁃ebral palsy was periventricular softening,with 468 cases,accounting for 52.71%.Followed by multiple malacia and atrophy,with 178 cases,accounting for 21.76%.Among the abnormal brain MRI manifestations of mental retardation,white matter myelination was the most common,with 67 cases,accounting for 41.88%.Followed by widening of the extracerebral space and ventriculomegaly,with 38 cases,accounting for 23.75%.Conclusion Brain MRI examination is of great value in speculating the pathological mechanism and predicting the prognosis of children with cerebral palsy,which is more important than that in children with mental retardation.

关 键 词：脑性瘫痪 头颅磁共振成像 智力障碍 GMFCS分级 韦氏智力测试 

分 类 号：R742.3[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]