摘要
目的探讨颅脑MRI与脑瘫类型、患儿胎龄之间的关系。方法回顾性分析224例痉挛型脑瘫患儿的MRI检查和临床资料。结果224例患儿痉挛型偏瘫27例、双瘫149例、四肢瘫48例;MRI异常201例(89.7%),其中偏瘫、双瘫、四肢瘫的异常率分别为100%、87.2%和91.7%。痉挛型双瘫以脑室周围白质软化(PVL)最常见,发生率79.2%,其他类型脑损伤少见。痉挛型四肢瘫脑损伤多种多样,以PVL、足月儿类型脑损伤、先天发育畸形为主要表现,发生率分别为45.8%、20.8%和18.8%。足月儿痉挛型偏瘫以半侧损伤为主,临床表现为一侧肢体运动障碍,上肢重,下肢轻;未成熟儿痉挛型偏瘫表现为单侧或双侧PVL,临床表现为下肢重、上肢轻的偏瘫。152例PVL患儿中,发生于未成熟儿108例(71.1%)、足月儿44例(28.9%)。足月儿类型脑损伤22例,发生于足月儿20例(90.9%)。未成熟儿脑损伤类型主要为PVL,主要见于未成熟儿脑瘫,也可发生于足月儿脑瘫。足月儿类型脑损伤主要见于足月儿脑瘫,未成熟儿少见。结论颅脑MRI表现与脑瘫的类型、出生胎龄密切相关。
Objective To investigate the relationship between magnetic resonance imaging（MRI） and the type of cerebral palsy （CP） and gestational age at birth. Methods The MRI and clinical data of 224 CP children with spastic type were analyzed retrospectively. Results Among these children, 27 cases had spastic hemiplegia, 149 had spastic diplegia, and 48 had spastic tetraplegia. 201 cases （89.7%） had abnormal MRI result. The abnormal rate of MRI in spastic hemiplegia, diplegia and tetraplegia were 100%, 87.20% and 91.7 %, respectively. Periventricular leukomalacia （PVL） was observed mostly in children with spastic diplegia, other types of brain lesions were uncommon. In spastic tetraplegia the lesions were more varied. Three predominated types of MRI abnormalities were： PVL （45.8 % ）, term-type brain injuries （20.8 % ） and congenital brain abnormalies （18.8 % ）. Unilateral lesions were observed mostly in children with hemiplegia spastic diplegia born at term who showed unilateral motor disorder and upper extremity were heavier than lower extremity. Unilateral and bilateral PVL were observed in children with hemiplegia spastic diplegia born at preterm who showed lower extremity were heavier than upper extremity. Of 152 cases with PVL, 108 cases （71.1 %） were preterm infants and 44 cases （28. 9%） were term infants. Of 22 cases with term-type brain injuries, 20 cases （90.9%） were term infants. PVL was most observed in preterm brain injuries and was observed most in preterm children but was also in term children. Termtype brain injuries （border-zone infarct, basal ganglia-thalamic lesion, subcortical leukomalacia, and multicystic encephalomalacia） were observed most in term and rare in preterm children. Conclusion The MRI findings in CP show a good correlation with type of CP and gestational age.
出处
《中国康复理论与实践》
CSCD
2007年第4期386-388,共3页
Chinese Journal of Rehabilitation Theory and Practice
关键词
脑性瘫痪
磁共振
出生胎龄
cerebral palsy
magnetic resonance imaging
gestational age
