正常婴儿与隐源性婴儿痉挛症患儿大脑皮层灰质的MR形态学定量分析

目的通过对脑灰质结构进行定量分析,寻找隐源性婴儿痉挛可能的发病部位、探讨发病机制。方法对16例平均年龄6.4个月的隐源性婴儿痉挛患儿和年龄、性别匹配的16例正常婴儿进行脑部高分辨磁共振解剖成像,借助SPM脑成像处理软件对磁共振图像进行解剖分割,用基于体素的形态学对比方法定量检测患儿组和对照组全脑灰质的体积,比较两组间的差异。结果隐源性婴儿痉挛组在左额下回(47区)、右颞上回(22区)、左中央后回(1～2区)、右额中回(9/10区)、右中央前回(6区)、右扣带回(31区),左颞中回(21区)和颞上回(38区)等灰质体积明显减少,与正常婴儿组比较,差异有显著性(P<0.001)。结论隐源性婴儿痉挛患儿额叶和颞叶的灰质体积明显减少,以额叶和颞叶为主的皮层结构异常可能是本组患儿的发病原因。

Voxel-based morphometry of gray matter structure in normal infants and infants with cryptogenic infantile spasms

Objective To detect possible etiological origin for cryptogenic infantile spasms (IS) in terms of gray matter volume by using voxel-based morphometry (VBM) method. Methods High resolution structural brain MR images were derived from 16 infants (mean aged 6.4 month) having IS and 16 matched normal infants. Image data were analyzed by SPM software using VBM method, including an automated segmentation procedure and standardized parametric statistics. Whole brain gray matter volumes were compared between 2 groups. Results In comparison with normal infants, the IS group showed significantly decreased gray matter volume in left inferior frontal gyrus, right superior temporal gyrus, left posterior central gyrus, right middle frontal gyrus, right precentral gyrus, right callosal gyrus, left middle temporal gyrus and left superior temporal gyrus (Bradmann area 47, 22, 1-2, 9/10, 6, 31, 21, and 38) (P<0.001, uncorrected). Conclusion Structural abnormalities in the frontal and temporal lobe cortex in infants with IS might be the possible mechanism for cryptogenic IS in the studied group.