磁共振成像和计算机X线断层照像术对婴儿痉挛病因和预后判断的意义

目的　探讨头颅磁共振成像 (MRI)和计算机X线断层照像术 (CT)对婴儿痉挛 (IS)的病因和预后判断的意义。方法　采用螺旋CT平扫和MRI扫描T1和T2加权相、反转恢复序列和磁共振血管成像等技术对4 2例IS颅脑病变进行检测和分析。结果　CT检查 14例发现异常 ,对脑萎缩、出血、粗大畸形和钙化显示较好 ;2 4例MRI扫描阳性 ,对脑白质软化或髓鞘化延迟、海马和脑干萎缩、缺氧缺血性脑病 (HIE)和核黄疸、结节性硬化、灰质异位及胼胝体和脑血管畸形等病变都具有良好诊断价值 ;MRI对IS预后判断应结合临床和年龄。结论　MRI和CT对探寻IS等癫潜在病因、评估预后和指导治疗具有重要意义 ,前者对脑白质软化与髓鞘化、HIE、海马萎缩、局限性脑发育不全和灰质异位等病变检测尤敏感。

Etiological diagnostic and prognostic values in infantile with spasms by magnetic resonance imaging and computed tomography

Objective To study the diagnostic and prognostic values by magnetic resonance imaging(MRI) and computed tomography(CT) for investigation of infantile spasms(IS).Methods Fourty-two patients with IS were retrospectively reviewed by CT scan and MRI T1W,T2W and inversion recovery (IR) and MRA techniques.Results Fourteen cases were found abnormal in CT,including encephalatrophy,hemorrhage,gross malformation and lesions with underlying calcification;MRI studies of 24/28 cases showed that MRI was the most appropriate imaging technique in diagnosis of the underlying substrate of patients with IS and other epilepsies,particularly in periventricular leuko malacia(PL),delayedmyelination(DM),hypxic-ischemic encephalopathy(HIE),kernicterus,tuberous sclerosis(TS),hippocampal sclerosis(HS),brainstematrophy,heterotopia,corpus callosum and vascular malformation,et al.MRI was also valuable for determining the prognoses of IS,but it should be combined with the clinical symptom and ages. Conclusions MRI and CT are highly important for the investigation and treatment of patients with IS; MRI is much more sensitive to exploration of neuropathology of infatile spasms,such as PL,DM,HIE,kernicteus,HS,heterotopias and focally cortical dysplasia.