磁共振成像在痉挛型与非痉挛型脑瘫鉴别诊断中的应用效果研究  

Study on the Application Effect of Magnetic Resonance Imaging in the Differential Diagnosis of Spasticand Non-Spastic Cerebral Palsy

作　　者：柳计强 彭雪辉 LIU Jiqiang;PENG Xuehui(Department of Magnetic Resonance Imaging,the Third Affiliated Hospital of Xinxiang Medical College,Xinxiang 453000,China;Department of Radiology Diagnosis,the Third Medical Center of the People's Liberation Army General Hospital,Beijing 100039,China)

机构地区：[1]新乡医学院第三附属医院核磁共振科,河南新乡453000 [2]解放军总医院第三医学中心放射诊断科,北京100039

出　　处：《临床医学工程》2025年第3期241-244,共4页Clinical Medicine & Engineering

基　　金：河南省医学科技攻关计划联合共建项目(项目编号:LHGJ20220642);北京医卫健康公益基金会医学科学研究基金资助(项目编号:YWJKJJHKYJJ-202409031129197323)。

摘　　要：目的 探讨磁共振成像(MRI)在痉挛型脑瘫(CP)和非痉挛型CP鉴别诊断中的应用效果。方法 选取89例接受MRI检查的CP患儿作为研究对象,比较痉挛型CP和非痉挛型CP的MRI征象。以最终临床诊断结果为金标准,评估MRI对痉挛型CP和非痉挛型CP的鉴别诊断效能。采用Kappa检验分析MRI诊断结果与金标准的一致性。结果 痉挛型CP患儿的脑白质损伤、脑室形态异常、脑沟脑裂异常占比均显著高于非痉挛型CP患儿(P <0.05)。以最终临床诊断结果为金标准,MRI鉴别诊断痉挛型CP和非痉挛型CP的敏感度、特异度、准确度分别为83.33%、 78.05%、 80.90%。Kappa检验结果显示,MRI鉴别诊断痉挛型CP和非痉挛型CP与金标准的一致性中等(Kappa值=0.615, P <0.001)。结论 痉挛型CP和非痉挛型CP的MRI征象存在明显差异,MRI检查对二者有较高的鉴别诊断效能。Objective To explore the application effect of magnetic resonance imaging(MRI)in the differential diagnosis of spastic cerebral palsy(CP)and non-spastic CP.Methods A total of 89 children with CP who underwent MRI examination were selected as the research subjects.The MRI features of spastic CP and non-spastic CP were compared.With the final clinical diagnosis results as the gold standard,the efficacy of MRI in the differential diagnosis of spastic CP and non-spastic CP was evaluated.Kappa test was used to analyze the consistency between MRI diagnostic results and the gold standard.Results The proportions of white matter injury,abnormal ventricular morphology,and abnormal sulci and fissures in children with spastic CP were significantly higher than those in children with non-spastic CP(P<0.05).With the final clinical diagnosis results as the gold standard,the sensitivity,specificity,and accuracy of MRI in the differential diagnosis of spastic CP from non-spastic CP were 83.33%,78.05%,and 80.90%,respectively.The Kappa test result showed that the consistency between MRI in the differential diagnosis of spastic CP and non-spastic CP and the gold standard was moderate(Kappa value=0.615,P<0.001).Conclusions The MRI features of spastic CP and non-spastic CP show significant differences,and MRI examination has a high efficacy in differential diagnosis of spastic CP and non-spastic CP.

关 键 词：磁共振成像 痉挛型脑瘫 非痉挛型脑瘫 鉴别诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学]