小儿脑性瘫痪TCD与CT诊断比较

目的观察经颅多普勒(transcranialDoppler,TCD)和CT在小儿脑性瘫痪(cerebralpalsy,CP)诊断中的应用情况。方法回顾性分析2015年8月至2018年9月我院46例均接受TCD和CT检查的CP患儿临床资料,纳入研究组;将同期接受TCD检查的30例正常儿童纳入对照组。观察TCD、CT对CP检查异常率,比较TCD对2组小儿大脑前动脉(ACA)、中动脉(MCA)、后动脉(PCA)及基底动脉(BA)平均血流速度(Vm)、血管阻力指数(RI)、血管搏动指数(PI)检测结果差异,观察CP患儿CT检查情况。结果 TCD对CP检查异常率与CT检查异常率差异无统计学意义(P>0.05)。研究组小儿ACA、MCA、PCA及BA Vm均低于对照组,RI、PI均高于对照组(P<0.05)。CP患儿CT可见脑室扩大、脑发育迟缓、脑萎缩、脑软化、蛛网膜下腔变宽等病理改变。结论 TCD与CT对CP诊断中均有一定价值,各具优势,临床可根据实际情况选择或联合使用。

TCD and CT Diagnosis of Cerebral Palsy in Children

Objective To observe the application of transcranial Doppler(TCD) and CT in the diagnosis of cerebral palsy(CP) in children. Methods The clinical data of 46 children patients with CP who underwent TCD and CT examinations in our hospital from August 2015 to September 2018 were retrospectively analyzed, and the patients were included in study group. Another 30 normal children who underwent TCD examination at the same time period were included in control group. The abnormal rates of TCD and CT on CP were observed, and the examination results of mean blood flow velocity(Vm) values of anterior cerebral artery(ACA), middle cerebral artery(MCA), posterior cerebral artery(PCA) and basilar artery(BA), vascular resistance index(RI) and vascular pulsatility index(PI) by TCD were compared between the two groups, and CT examination situation was observed in children patients with CP. Results There was no significant difference in the abnormal rate of TCD examination and CT examination on CP(P>0.05). The Vm values of ACA, MCA, PCA and BA in study group were lower than those in control group, and the RI and PI were higher than those in control group(P<0.05). CT of children patients with CP showed pathological changes such as ventricular enlargement, brain development retardation, brain atrophy, brain softening and subarachnoid widening. Conclusion Both TCD and CT have certain value in the diagnosis of CP. Each has its own advantages, and the examination method can be selected or used according to the actual situation.