脑性瘫痪的MRI特征

目的:探讨脑性瘫痪(脑瘫)患儿的头颅MRI表现及其与脑瘫类型的关系。方法:回顾性分析81例脑瘫患儿的临床资料与MRI表现。结果:81例脑瘫患儿MRI异常率为85.2%,痉挛型双瘫、四肢瘫、偏瘫、不随意运动型脑瘫、共济失调型脑瘫、肌张力低下型脑瘫和混合型脑瘫MRI异常率分别为92.9%、100%、100%、60%、87.5%、50%和81.8%。各类型脑瘫的MRI异常表现不同,痉挛型双瘫以脑室周围白质软化(PRL)为主,偏瘫型突出表现为单侧脑损伤,四肢瘫表现为广泛、弥漫、双侧脑损伤,不随意运动型表现为基底节病变或PVL,共济失调型绝大部分存在先天性小脑发育不全。结论:MRI有助于评价各型脑瘫的病理特点,对脑瘫病因的推测有帮助。

Magnetic resonance imaging findings in cerebral palsy

Objective：To study the clinical and neurological abnormalities in children with cerebral palsy（CP） and to attempt to correlate the types of CP with radiological abnormalities detected by magnetic resonance imaging（MRI） of the brain.Methods：All of the 81 hospitalized CP cases（28 with spasticdiplegia,6 with tetraplegia,12 with hemiplegia,10 with athetosis,6 with hypotonic,8 with ataxia,and 11 with mixed） were examined neurologically and their perinatal history was reviewed.Their cranial MRI findings were studied.Results：MRI abnormalities were found in 69 of the 81 cases and abnormal rates of spastic diplegia,tetraplegia,hemiplegia,athetosis,hypotonic,ataxia and mixed were 92.9%,100%,100%,60%,50%,87.5% and 81.8%,respectively.Children with spastic diplegia had significant periventricular leukomalacia（PVL）,children with hemiplegia,almost had unilateral lesions on neuroimaging.Spastic tetraplegia was associated with extensive,bilateral,diffuse brain damage.The abnormalities with athetoid cerebral palsy were mainly located in the basal ganglia region whereas the major abnormality in premature infants was PVL.Children with ataxic cerebral palsy,almost showed congenital cerebellum dysplasia on brain imaging.Conclusion：Radiological abnormalities of the brain were correlated with CP types;MRI was useful in revealing underlying brain abnormalities and speculating on the etiology of cerebral palsy.