脑性瘫痪患儿MRI表现及危险因素分析

目的分析脑性瘫痪(脑瘫)患儿磁共振成像(MRI)表现及其与脑瘫类型、危险因素的关系。方法纳入2016年9月~2018年9月于我院明确诊断的520例脑瘫患儿展开回顾性分析,观察不同脑瘫类型、危险因素患儿的MRI检查结果。结果①520例脑瘫患儿中MRI表现异常441例,异常率84.80%,以脑室周围软化(PVL)(18.85%)、侧脑室扩大(12.12%)、脑萎缩(10.38%)发生率较高。②共济失调型脑瘫患儿MRI异常率(88.00%)最高,混合型脑瘫患儿MRI异常率(77.36%)最低,痉挛型、不随意运动型脑瘫患儿MRI异常率分别为85.93%、81.82%,以PVL、侧脑室扩大、脑萎缩、基底节病变多见。③具缺氧窒息、早产因素脑瘫患儿MRI异常率分别为88.12%、77.27%,均以PVL、侧脑室扩大、脑萎缩多见;具出生低体质量因素脑瘫患儿MRI异常率为79.49%,以PVL、脑萎缩、基底节病变多见;具病理性黄疸因素脑瘫患儿MRI异常率为58.41%,以基底节病变、局灶性脑缺血、髓鞘发育不良多见。结论MRI检查对脑瘫的临床诊断具重要价值,其结果或与患儿脑瘫类型及危险因素相关。

MRI Findings and Risk Factors of Children with Cerebral Palsy

Objective To analyze the magnetic resonance imaging(MRI)findings of children with cerebral palsy(CP)and their relationship with the type and risk factors of CP.Methods A retrospective analysis was performed on 520 children with CP diagnosed in the hospital from September 2016 to September 2018.MRI findings of children with different types of CP and risk factors were observed.Results①Among 520 children with CP,441 cases had abnormal MRI findings(84.80%).The incidence rates of periventricular leukomalacia(PVL)(18.85%),enlargement of lateral ventricles(12.12%)and brain atrophy(10.38%)were relatively higher.②The abnormal rate of MRI(88.00%)was the highest in children with ataxia type CP and was the lowest(77.36%)in children with mixed CP.The abnormal rates of MRI in children with spastic type and dyskinetic CP were 85.93%and 81.82%,respectively.Besides,the proportions of PVL,enlargement of lateral ventricles,brain atrophy and basal ganglia lesions were relatively higher.③The abnormal rate of MRI in children with CP and hypoxic asphyxia was 88.12%,and PVL,enlargement of lateral ventricles and brain atrophy were more common.The abnormal rate of MRI in children with CP and premature birth was 77.27%,and PVL,enlargement of lateral ventricles and brain atrophy were more common.The abnormal rate of MRI in children with CP and low body mass was 79.49%,and PVL,brain atrophy and basal ganglia lesions were more common.The abnormal rate of MRI in children with CP and pathological jaundice was 58.41%,and basal ganglia lesions,focal cerebral ischemia and myelin dysplasia were more common.Conclusion MRI is of great value in the clinical diagnosis of CP.The results may be related to the type and risk factors of CP.