摘要
目的应用扩散张量成像(diffusion tensor imaging,DTI)及扩散纤维束成像(diffusion tensor tractography,DTT)评价轻度脑室旁脑白质软化症(perventricular leukomalacia,PVL)患儿脑白质的损伤,探讨DTI及DTT对轻度脑室旁白质软化症的诊断价值。方法应用GE Signa Excite 1.5T磁共振扫描仪对25例PVL患儿和月龄及性别匹配的25例健康对照组分别进行头颅MRI平扫及DTI检查。测量2组患儿胼胝体膝部、胼胝体压部、双侧内囊前肢、双侧内囊后肢、视放射、大脑脚及上纵束的各向异性分数(fractional anisotropy,FA)值及平均扩散系数(average diffusion coffient,ADC)值。对2组感兴趣测量结果进行独立样本t检验,分析2组间FA值及ADC值有无差异,分析有差异部位与PVL患儿临床症状的关系。对2组患儿行扩散张量纤维束成像,对比观察两组患儿纤维束的走行及分布。结果 PVL组患儿胼胝体压部、视放射及上纵束FA值显著低于正常对照组(P<0.05或<0.01);PVL组胼胝体压部及上纵束ADC值显著高于正常对照组(P<0.05或<0.01)。扩散张量纤维束成像显示:PVL组患儿胼胝体压部周围的纤维束较正常对照组稀疏、中断、紊乱。结论轻度PVL患儿的脑白质损伤多发生于胼胝体压部、视放射及上纵束,是其合并双下肢痉挛性瘫痪、视力损害、精神运动发育迟缓的主要原因。DTI及DTT可以评价PVL患儿脑白质损伤的范围及程度,为临床治疗及随访提供依据。
Objective To assess white matter injury in patients with periventricular leukomalacia（PVL）by diffusion tensor imaging（DTI）and diffusion tensor tractography（DTT）,to evaluate the diagnostic value of DTI and DTT on mild PVL.Methods Conventional MRI and DTI were performed in 25 patients with PVL and 25age-matched normal（NC）control subjects.All subjects were performed with GE Signa Excite 1.5-T MR system.We measured fractional anisotropy（FA）and average diffusion coffient（ADC）of 7selected regions which included corpus callosum genu,splenium of corpus callosum,bilateral anterior limb of the internal capsule,bilateral posterior limb of internal capsule,bilateral optic radiation,bilateral cerebral pedunculus and superior longitudinal fasciculus in patients with PVL（n=25）and NC（n=25）.We performed independent sample t-test in FA and ADC of each region of interest between PVL patients and controls.Results Compared with NC the FA values in the splenium of corpus callosum,optic radiation and superior longitudinal fasciculus with PVL were significantly reduced（P0.05or0.01）.ADC values of the splenium of corpus callosum and superior longitudinal fasciculus were higher than those of NC.DTT showed that the fiber bundle around the corpus callosum of PVL group was more sparse,interrupted and disordered than that of NC group.Conclusion White matter injury in patients with mild PVL were in splenium of corpus callosum,and is the main reason for PVL with pastic cerebral palsy,visual impairment and mental motor development.DTI and DTT can evaluate the extent and severity of white matter damage in children with PVL,and provide evidence for clinical treatment and follow-up.
出处
《河北医科大学学报》
CAS
2015年第11期1285-1288,共4页
Journal of Hebei Medical University
基金
河北省医学科学研究重点课题(20120294)
关键词
白质软化病
脑室周围
弥散张量成像
磁共振成像
leukomalacia
periventricular
diffusion tensor imaging
magnetic resonance imaging
