【摘要】 目的 评价深部灰质损伤（DGMI）的脑瘫（CP）患儿MRI分级标准的临床应用价值。方法 回顾性分析经MRI诊断的26例DGMI的CP儿童,行常规头颅MRI平扫（T₁ WI、T₂ WI）,由2名影像诊断医师根据最新欧洲小儿脑瘫监测组织（SCPE）发布的MRI分级标准,分别独立评价患儿头颅MRI图像2次;随后记录粗大运动功能分级（GMFCS）、手功能分级（MACS）,采用Kappa检验计算MRI分级的组内、组间一致性,将MRI分级分别与GMFCS/MACS分级进行相关分析。结果 按照MRI DGMI分级方法,高年资、低年资影像医生前后2次评估组内一致性Kappa值分别为0.885、0.831（P<0.001）;第1次评估高年资影像医生与低年资影像医生的组间一致性Kappa值0.776（P<0.001）,第2次评估高年资影像医生与低年资影像医生的组间一致性Kappa值0.707（P<0.001）;MRI分级与GMFCS分级（r=0.617,P<0.001）、MACS分级均呈正相关（r=0.731,P<0.001）。结论 DGMI的CP儿童MRI分级方法可靠,与临床运动量表相关性好,有助于CP儿童病情严重程度的判断,是其潜在的预后因子。更多还原

【Abstract】 Objective To evaluate the clinical application of MRI classification criterion in cerebral palsy（CP） children with deep gray matter injury（DGMI）.Methods A total of 26 CP children with DGMI diagnosed by MRI were analyzed retrospectively.Conventional brain MRI（T₁ WI,T₂ WI） was performed.Based on MRI diagnostic criteria published by the latest Surveillance of Cerebral Palsy in Europe（SCPE）,the MRI images of children’ s brain were evaluated by two radiologists twice respectively.Gross motor function classification system（GMFCS） and manual ability classification system（MACS） were recorded subsequently.Kappa test was used to calculate intra-group and inter-group consistency of MRI classification,and related analysis between MRI classification and GMFCS or MACS classification were performed respectively.Results According to the classification method of deep gray matter injury in MRI,the intra-group consistency Kappa values of the senior and junior radiologists in two evaluations were 0.885,0.831（P<0.001） respectively.The inter-group consistency Ka[[a value between the senior and junior radiologists in the first evaluation was 0.776（P<0.001）,and in the second evaluation was 0.707（P <0.001）.MRI classification was positively correlated with GMFCS classification（r=0.61 7,P<0.001） and MACS classification（r=0.731,P<0.001）.Conclusion The MRI classification method of CP children with DGMI is reliable and has good correlation with clinical exercise scale,it is a potential prognostic factor which contributes to the judgment of severity of children with CP.更多还原