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山东大学学报 (医学版) ›› 2017, Vol. 55 ›› Issue (12): 36-42.doi: 10.6040/j.issn.1671-7554.0.2017.825

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1 060例脑性瘫痪患者MRI表现及其与临床特征的关系

王耸1,2,程洪斌2,伊龙2,王培申2,孙宪昶3,安沂华1,2   

  1. 1.锦州医科大学武警总医院研究生培养基地, 北京 100039;2.中国人民武装警察部队总医院功能神经外科, 北京 100039;3.中国人民武装警察部队总医院CT科, 北京 100039
  • 出版日期:2017-12-20 发布日期:2022-09-27
  • 通讯作者: 安沂华. E-mail:riveran@163.com

Relationship between magnetic resonance imaging and clinical characteristics of cerebral palsy based on 1 060 cases

WANG Song1,2, CHENG Hongbin2, YI Long2, WANG Peishen2, SUN Xianchang3, AN Yihua1,2   

  1. 1. Postgraduate Training Base, General Hospital of Chinese Peoples Armed Police Forces, Jinzhou Medical University, Beijing 100039, China;
    2. Department of Functional Neurosurgery, the General Hospital of Chinese Peoples Armed Police Forces, Beijing 100039, China;
    3. CT Department, the General Hospital of Chinese Peoples Armed Police Forces, Beijing 100039, China
  • Online:2017-12-20 Published:2022-09-27

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摘要： 目的 探讨脑性瘫痪(脑瘫)患者的磁共振成像(MRI)表现及其与脑瘫类型、高危因素的关系。 方法 回顾性分析病历完整并最终确诊的1 060例脑瘫患者资料,包括基本信息、高危因素、MRI表现等。 结果 1 060例患者中头颅MRI表现异常占82.17%,其中以脑室旁(或周围)白质软化症(PVL)(27.93%)、侧脑室扩大(13.11%)、脑萎缩(10.85%)、髓鞘发育不良(10.28%)及胼胝体发育不良(10.19%)等多见。痉挛型脑瘫患者MRI异常率为83.65%,其中以PVL、侧脑室扩大、髓鞘发育不良多见;不随意运动型患者MRI异常率为60.98%,其中以基底节异常信号、PVL、侧脑室扩大多见;共济失调型脑瘫患者MRI异常率为88.57%,其中以小脑发育不良、胼胝体发育不良、PVL多见;混合型脑瘫患者MRI异常率为75.90%。PVL、侧脑室扩大、脑裂畸形在早产患者中比例较高且差异有统计学意义(P均<0.05);PVL、髓鞘发育不良、局灶性脑缺血在具有缺氧因素患者中比例较高且差异有统计学意义(P均<0.05);基底节异常信号、局灶性脑缺血在具有黄疸因素患者中比例较高且差异有统计学意义(P均<0.05)。 结论 MRI检查是脑瘫患儿的首选辅助检查方法,其结果与患者脑部病变及脑瘫的类型、高危因素密切相关。

关键词: 脑性瘫患, 磁共振成像, 高危因素

Abstract: Objective To analyze the relationship between the brain magnetic resonance imaging(MRI)and cerebral palsy types/risk factors. Methods Information, including age, risk factors, clinical classification and MRI findings, of 1 060 hospitalized patients with cerebral palsy was reviewed. Results Among the 1 060 patients, the abnormal rate of brain MRI results was 82.17%, in which periventricular leukomalacia(PVL)(27.93%), enlargement of the lateral ventricles(13.11%), brain atrophy(10.85%), delayed myelination(10.28%), and abnormal corpus callosum(10.19%)were the common types. The abnormal rate of spastic cerebral palsy was 83.65%, in which PVL, enlargement of the lateral ventricles, and delayed myelination were the commen types. The abnormal rate of dyskinetic cerebral palsy was 60.98%, in which basal ganglia damage, PVL and enlargement of the lateral ventricles were the common types. The abnormal rate of ataxic cerebral palsy was 88.57%, in which cerebellar hypoplasia and abnormal corpus callosum were the common types. The abnormal rate of mixed type was 75.90%. Proportions of PVL, enlargement of the lateral ventricles and schizencephaly were higher in prematurity patients(all P< 0.05). Proportions of PVL, delayed myelina- 山 东 大 学 学 报 (医 学 版)55卷12期 -王耸,等.1 060例脑性瘫痪患者MRI表现及其与临床特征的关系 \=-tion, and focal cerebral ischemia were higher in patients with hypoxia asphyxia(all P<0.05). Proportions of basal ganglia damage and focal cerebral ischemia were higher in patients with pathologic jaundice(both P<0.05). Conclusion MRI has important clinical significance in children with cerebral palsy and its changes are closely related to cerebral palsy types and risk factors.

Key words: Cerebral palsy, Magnetic resonance imaging, Risk factors

中图分类号: 

  • R741
[1] Rosenbaum P, Paneth N, Leviton A, et al. A report: the definition and classification of cerebral palsy April 2006[J]. Dev Med Child Neurol Suppl, 2007, 109: 8-14.
[2] Blair E, Watson L. Epidemiology of cerebral palsy[J]. Semin Fetal Neonatal Med, 2006, 11(2): 117-125.
[3] Goldsmith S, McIntyre S, Smithers-Sheedy H, et al. An international survey of cerebral palsy registers and surveillance systems[J]. Dev Med Child Neurol, 2016, 58(Suppl 2): 11-17.
[4] Oskoui M, Coutinho F, Dykeman J, et al. An update on the prevalence of cerebral palsy: a systematic review and meta-analysis[J]. Dev Med Child Neurol, 2013, 55(6): 509-519.
[5] Bax M, Tydeman C, Flodmark O. Clinical and MRI correlates of cerebral palsy: the European Cerebral Palsy Study[J]. JAMA, 2006, 296(13): 1602-1608.
[6] Nelson KB, Blair E. Prenatal factors in singletons with cerebral palsy born at or near term[J]. N Engl J Med, 2015, 373(10): 946-953.
[7] Jindal P, MacDermid JC, Rosenbaum P, et al. Perspectives on rehabilitation of children with cerebral palsy: exploring a cross-cultural view of parents from India and Canada using the international classification of functioning, disability and health[J]. Disabil Rehabil, 2017: 1-11. doi: 10.1080/09638288.2017.1356383.
[8] Graham HK, Rosenbaum P, Paneth N, et al. Cerebral palsy[J]. Nat Rev Dis Primers, 2016, 2: 15082.
[9] Givon U. Management of the spastic hip in cerebral palsy[J]. Curr Opin Pediatr, 2017, 29(1): 65-69.
[10] Hansmann J, Apfaltrer P, Zoellner FG, et al. Correlation analysis of dual-energy CT iodine maps with quantitative pulmonary perfusion MRI[J]. World J Radiol, 2013, 5(5): 202-207.
[11] Kataoka H, Kiriyama T, Taoka T, et al. Comparison of brain 3.0-T with 1.5-T MRI in patients with multiple sclerosis: a 6-month follow-up study[J]. Clin Neurol Neurosurg, 2014, 121: 55-58.
[12] Smithers-Sheedy H, McIntyre S, Gibson C, et al. A special supplement: findings from the Australian Cerebral Palsy Register, birth years 1993 to 2006[J]. Dev Med Child Neurol, 2016, 58(Suppl 2): 5-10.
[13] Koman LA, Smith BP, Shilt JS. Cerebral palsy[J]. Lancet, 2004, 363(9421): 1619-1631.
[14] Derinkuyu BE, Ozmen E, Akmaz-Unlu H, et al. A magnetic resonance imaging finding in children with cerebral palsy: symmetrical central tegmental tract hyperintensity[J]. Brain Dev, 2017, 39(3): 211-217.
[15] Truwit CL, Barkovich AJ, Koch TK, et al. Cerebral palsy: MR findings in 40 patients[J]. AJNR Am J Neuroradiol, 1992, 13(1): 67-78.
[16] Lundy C, Lumsden D, Fairhurst C. Treating complex movement disorders in children with cerebral palsy[J]. Ulster Med J, 2009, 78(3): 157-163.
[17] Robinson MN, Peake LJ, Ditchfield MR, et al. Magnetic resonance imaging findings in a population-based cohort of children with cerebral palsy[J]. Dev Med Child Neurol, 2009, 51(1): 39-45.
[18] Hoon AH, Vasconcellos FA. Pathogenesis, neuroimaging and management in children with cerebral palsy born preterm[J]. Dev Disabil Res Rev, 2010, 16(4): 302-312.
[19] Msall ME, Limperopoulos C, Park JJ. Neuroimaging and cerebral palsy in children[J]. Minerva Pediatr, 2009, 61(4): 415-424.
[20] Kwong KL, Wong YC, Fong CM, et al. Magnetic resonance imaging in 122 children with spastic cerebral palsy[J]. Pediatr Neurol, 2004, 31(3): 172-176.
[21] Towsley K, Shevell MI, Dagenais L. Population-based study of neuroimaging findings in children with cerebral palsy[J]. Eur J Paediatr Neurol, 2011, 15(1): 29-35.
[22] Nelson KB. Can we prevent cerebral palsy?[J]. N Engl J Med, 2003, 349(18): 1765-1769.
[23] Hack M, Taylor HG, Drotar D, et al. Chronic conditions, functional limitations, and special health care needs of school-aged children born with extremely low-birth-weight in the 1990s[J]. JAMA, 2005, 294(3): 318-325.
[24] 尹向云,薛辛东,富建华.早产儿脑白质损伤早期磁共振成像改变及其高危因素分析[J].中国实用儿科杂志, 2010, 25(10): 778-782. YIN Xiangyun, XUE Xindong, FU Jianhua. Research on the MRI and related factors in the preterm infants with early cerebral white matter damage[J]. Chinese Journal of Practical Pediatrics, 2010, 25(10): 778-782.
[25] Okumura A, Hayakawa F, Kato T, et al. MRI findings in patients with spastic cerebral palsy. I: correlation with gestational age at birth[J]. Dev Med Child Neurol, 1997, 39(6): 363-368.
[26] Krägeloh-Mann I, Horber V. The role of magnetic resonance imaging in furthering understanding of the pathogenesis of cerebral palsy[J]. Dev Med Child Neurol, 2007, 49(12): 948.
[27] Alderliesten T, de Vries LS, Staats L, et al. MRI and spectroscopy in(near)term neonates with perinatal asphyxia and therapeutic hypothermia[J]. Arch Dis Child Fetal Neonatal Ed, 2017, 102(2): F147-F152.
[28] van Haastert IC, de Vries LS, Eijsermans MJ, et al. Gross motor functional abilities in preterm-born children with cerebral palsy due to periventricular leukomalacia[J]. Dev Med Child Neurol, 2008, 50(9): 684-689.
[29] Olusanya BO, Ogunlesi TA, Kumar P, et al. Management of late-preterm and term infants with hyperbilirubinaemia in resource-constrained settings[J]. BMC Pediatr, 2015, 15: 39. doi: 10.1186/s12887-015-0358-z.
[30] Wu YW, Kuzniewicz MW, Wickremasinghe AC, et al. Risk for cerebral palsy in infants with total serum bilirubin levels at or above the exchange transfusion threshold: a population-based study[J]. JAMA Pediatr, 2015, 169(3): 239-246.
[31] 汤行录,陈翔,陈伟,等.慢性核黄疸所致脑性瘫痪的磁共振成像特征及临床意义[J].中国康复理论与实践, 2009, 15(4): 357-359. TANG Xinglu, CHEN Xiang, CHEN Wei, et al. MRI features in children with cerebral palsy induced by chronic kernicterus[J]. Clin J Rehabil Theory Pract, 2009, 15(4): 357-359.
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