论著-头颈部
MRI对脑瘫患儿的诊断价值及意义
作者:周坤生1 朱先清1 张安山2 郭 新1 陈 芳1
所属单位:1.安徽省六安市第二人民医院磁共 振室 (安徽 六安 237008) 2.安徽省六安市第二人民医院康复 医学科 (安徽 六安 237008)
PDF摘要
目的探讨MRI在小儿脑瘫诊断中 的价值及意义。方法 回顾性分析2013年5 月至2015年1月于我院治疗并确诊的CP患 儿25例,对其MRI影像学分类及临床分型 进行总结分析;结果 全部25例CP患儿经 MRI检查结果正常为6例、异常为19例, 总阳性率为76%。依据影像学分类将脑瘫 分为,脑白质病变12例(48%)、胼胝体病 变5例(20%)、软化灶3例(12%)、脑萎缩2 例(8%);脑白纸病变CP患儿中6例为四肢 瘫、1例为双瘫、2例为偏瘫、1例为肌张 力低下型、2例为混合型;胼胝体病变5例 中,3例为四肢瘫、2例为即张力低下型; 基底节软化灶3例中,1例为四肢瘫、2例 为偏瘫;脑萎缩2例均表现为四肢瘫。痉 挛型四肢瘫、双瘫、偏瘫阳性率分别为 80%、100%、80%,肌张力减低型阳性检出 率为75%,混合型阳性检出率为66.6%; 结论 MRI检查可以作为检查脑内病变部位 和性质的的首选方法,可以确切提示脑部 病变的性质、部位和范围,对小儿CP的病 因分析、指导用药和判断预后均具有重要 价值,适宜临床推广使用。
Objective To evaluate the value of MRI in the diagnosis of children with cerebral palsy and significance. Methods Were retrospectively analyzed in May 2013 to January 2013 in our hospital treatment and diagnosis of CP children with 25 cases, MRI imaging to its classification and summarize clinical classification analysis. Results all 25 cases of CP children with normal by MRI examination results for 6 cases, abnormal for 19 cases, total positive rate was 76%. Based on radiographic classification will be divided into cerebral palsy, 12 cases of cerebral white matter lesions (48%), the subcallosal sacral body lesions in 5 cases (20%), softening oven in 3 patients (12%), 2 cases of brain atrophy (8%), 6 patients with brain lesions in children with CP, white paper for quadriplegics, 1 case for double collapsed, 2 cases of hemiplegia, 1 case for low muscle tone, 2 cases of mixed type; Subcallosal sacral body lesions in 5 cases, 3 cases of tetraplegia type, 2 cases as the tension is low; Basal ganglia softening oven in 3 cases, 1 case of quadriparesis, 2 cases of hemiplegia; Brain atrophy in 2 cases were presented with tetraplegia. Spasm, double paralysis, hemiplegia type tetraplegia positive rate were 80%, 100%, 80%, reducing muscle tension type positive detection rate of 75%, mixed type positive detection rate is 66.6%. Conclusion MRI can be used as a check of pathological changes of the brain and the nature of the preferred method, can be exactly indicate the nature of brain lesions, location and scope, analysis on the cause of children with CP, guiding medication and judging the prognosis has important value, suitable for clinical use.
【关键词】小儿脑性瘫痪;MRI诊断
【中图分类号】R742.3 ;R445.2
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2016.01.012
前言
小儿脑性瘫痪(Cerebral Palsy CP)主要是指脑部的运动中枢在 妊娠时、出生后或生产时因早产、脑缺氧缺血、产伤、先天性脑发育 异常、核黄疸和先天性宫内感染等多方面因素影响而造成患儿运动功 能障碍的一种非进行性脑病变,常常发展为感官、平衡能力不佳,智 力、认知、语言及学习等方面能力的严重障碍,由于各种功能性障碍 而导致患儿病情的进一步发展恶化[1]。目前,小儿CP临床诊断主要以 神经系统症状、运动障碍和姿势异常等临床表现为依据,但由于小儿 CP的早期症状并不典型,确诊较为困难,而MRI所提供的神经影像学检 查可以为CP患儿提供更加客观的临床证据,阳性率较高,有助于早期 诊断和干预[2]。本研究通过对MRI影像学表现依据,探讨其在小儿CP诊 断中的应用价值,详细报道如下。
中国CT和MRI杂志
第14卷, 第 1 期
2016年01月
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