常规磁共振序列联合ASL在儿童局灶性皮层发育不良中的诊断价值  

Diagnostic Value of Conventional MRI Sequences Combined with Arterial Spin Labeling Scanning with Focal Cortical Dysplasia in Children

作　　者：梁莎[1] 唐云静 梁玄菁 陈晓华[1] Liang Sha;Tang Yunjing;Liang Xuanjing;Chen Xiaohua(Department of Radiology,The Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning,Guangxi 530000)

机构地区：[1]广西壮族自治区妇幼保健院放射科,广西南宁530000

出　　处：《现代医用影像学》2024年第7期1189-1192,共4页Modern Medical Imageology

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20200997)。

摘　　要：目的:分析局灶性皮质发育不良(FCD)患儿常规MRI序列及动脉自旋标记(ASL)的扫描图像,探讨其对FCD的诊断价值。方法:回顾性分析2021年7月至2023年8月经病理确诊为FCD的30例患儿MRI图像,包括常规MRI T1WI、T2WI、FLAIR序列及ASL扫描序列,分析FCD不同分型的MRI影像学特点,并对ASL图像经后处理获得病变区脑血流量(CBF)值及同水平对侧正常区CBF值进行比较,计算常规MRI序列及常规MRI序列联合ASL扫描序列诊断FCD的准确率。结果:常规MRI序列评估结果阳性21例,准确率为70%。FCD I型6例,主要表现为局部脑组织容积偏小,灰白质模糊;FCD II型7例,以皮层增厚,皮层及皮层下片状T1WI稍低信号,T2WI高信号,T2-FAIR高信号为主,典型者呈Tansmantle征;FCD III型8例,合并海马硬化、肿瘤、血管畸形。常规MRI序列及ASL联合扫描示27例灌注异常,准确率为90%,27例病灶区CBF值[(48.15±6.00)mL/(100g·min)]低于对侧正常区CBF值[(79.66±6.53)mL/(100g·min)](t=18.458,P<0.001)。结论:不同分型FCD具有特征性影像表现,但I型病灶较隐匿,II型典型表现出现概率少,容易漏诊,III型容易被合并病灶掩盖,ASL扫描序列有助于FCD病灶的检出及定位,与常规MRI序列联合检查可进一步提高诊断FCD的准确率。Objective:To analyze the conventional MRI sequences and arterial spin labeling(ASL)scanning images of children with focal cortical dysplasia(FCD),and to evaluate their values to the diagnosis of FCD.Methods:The MRI images of 30 children with FCD diagnosed by pathology from July 2021 to August 2023 were analyzed retrospectively,including the conventional MRI TIWI,T2WI,FLAIR sequences,and ASL scan sequences.Then,analysis of MRI imaging features of FCD classification.The cerebral blood flow(CBF)values of the lesion area and the normal contralateral area were obtained by post-processing of ASL images and were compared.The accuracy rates of conventional MRI sequences,and conventional MRI sequences combined with ASL scan sequences in the diagnosis of FCD were calculated.Results:21 cases were positive in conventional MRI sequence evaluation,with an accuracy of 70%.6 FCD typeⅠ,the main performances of MRI are small local brain volume and blurred gray and white matter.7 FCD type II,MRI showed cortical thickening,cortical and subcortical patchy T1WI slightly hypointense,T2WI hyperintense,T2-FLAIR hyperintense,and typical Tansmantle sign.8 FCD typeⅢis often complicated with hippocampal sclerosis,tumors and vascular malformation.Conventional MRI sequence and ASL scan showed perfusion abnormality in 27 cases,with an accuracy of 90%.CBF value was lower in the lesion area[(48.15±6.00)mL/(100g·min)]than that in the contralateral normal area in 27 cases receiving ASL scan[(79.66±6.53)mL/(100 g·min)](t=18.458,P<0.001).Conclusion:Dfferent types of FCD have characteristic imaging findings.unfortunately,typeⅠimaging manifestations are often subtle.The probability of appearances is not high so easy to miss diagnosis in typeⅡ.typeⅢis difficult to distinguish due to obscured by combined lesions.ASL scan sequence is helpful for the detection and location of FCD lesions,and combined with conventional MRI sequence can further improve the diagnostic accuracy rate of FCD.

关 键 词：局灶性皮层发育不良 儿童 磁共振成像 动脉自旋标记 

分 类 号：R445.2[医药卫生—影像医学与核医学] R742.1[医药卫生—诊断学]