【摘要】 目的探讨磁共振成像(MRI)检测痉孪型脑瘫(SCP)患儿大脑皮层形态学变化的价值。方法回顾性收集2020年09月至2021年09月于蚌埠市第一人民医院确诊的SCP患儿(SCP组)45例,并纳入性别、年龄相匹配的健康儿童45例作为对照组,均进行3DT1结构像全脑扫描,使用Free Surfer软件处理图像获取大脑皮层各脑区形态学数据。使用t检验和多因素方差分析对2组数据进行统计学分析,采用Spearman秩相关性分析SCP组中具有统计学意义的脑区与运动功能分级(GMFCS)及相大运动功能量表(GMFM)评分的相关性。结果 SCP组两侧额上回、左侧扣带回、右侧楔前叶、右侧颞中回及左侧中央前回的皮层体积均显著低于对照组(P<0.05),SCP组两侧额上回、右侧额中回、左侧扣带回、右侧颞中回及左侧中央前回的皮层表面积均显著低于对照组(P<0.05),SCP组两侧中央前回、扣带回及左侧额上回的皮层厚度均显著低于对照组P<0.05),SCP组有统计学意义的脑区与粗大运动功能分级、精细运动功能分级均无明显相关性,但双侧额上回、左侧扣带回及左侧中央前回与GMFM-88评分具有显著相关性(P<0 05)。结论MRI扫描痉挛型脑瘫患儿分析大脑皮层形态学变化,发现部分脑区体积、表面积及皮层厚度较正常儿童减小,两侧额上回、左侧扣带回及左侧中央前回和患儿执行功能障碍及运动功能损伤严重程度具有相关性,为临床精准诊疗及预后评估提供一定帮助。更多还原

【Abstract】 Objective To investigate the value of magnetic resonance imaging(MRI) in detecting cerebral cortex morphological changes in children with spastic cerebral palsy(SCP).Methods Forty-five children with SCP diagnosed in The First People’s Hospital of Bengbu(SCP group) from September 2020 to September 2021 were retrospectively collected,and 45 healthy children matched for gender and age were enrolled as the control group.Whole brain 3DT1 structural imaging was performed,and morphological data of cerebral cortex regions were obtained by using Free Surfer software.T test and multivariate analysis of variance were used for statistical analysis of the two groups of data,and Spea rman rank correlation analysis was used for the correlation between the brain regions with motor function grading and GMFM(Gross Motor Function Test Scale) in SCP group.Results Observation group on both sides of the forehead,left cingulate gyrus,right precuneus,last time back in the right temporal and left the co rtex of precentral gyrus volume we re significa ntly lower than control group(P<0.05),the observation group on both sides of the forehead,the last time the right amount in the back,the left cingulate gyrus,right back and left back to before the central cortex in the temporal surface a rea were significa ntly lower than control group(P<0.05),The cortical thickness of bilateral anterior central gyrus,cingulate gyrus and left superior frontal gyrus in the observation group was significantly lower than that in the control group(P<0.05).There was no significant correlation between the brain areas with gross motor function and fine motor function in the observation group.However,bilateral superior frontal gyrus,left cingulate gyrus and left anterior central gyrus were significa ntly correlated with GMFM-88 score(P<0.05).Conclusion MRI scan type spasm cerebral palsy and analysis of cerebral cortex morphology change,can be found that part of the brain volume,surface area and thickness of the cortex than normal children is reduced,on both sides of the forehead,left cingulate gyrus and the left side of the last time the central front and back executive dysfunction and motor function in children with injury severity correlation,it provides some help for clinical accurate diagnosis and prognosis evaluation.更多还原