摘要
目的探讨高分辨核磁共振成像(MRI)在儿童局灶性皮质发育不良(Focal cortical dysplasia,FCD手术中的效果及价值。方法回顾性分析2013年7月—2018年7月于山东大学齐鲁儿童医院经手术病理证实的143例FCD患儿的MRI及临床资料,年龄5月龄~12.5岁,既往无治疗史,分析其MRI征象:①轻度局灶性灰白质分界模糊;②明显局灶性灰白质分界模糊;③皮质结构增厚;④皮质结构变薄;⑤Transmantle征(白质内向脑室方向延伸锥形异常信号);⑥灰质内信号异常;⑦白质内信号异常;⑧节段性或脑叶萎缩/发育不全与局部白质体积缩小;⑨异常脑沟和脑回形态,并按照上述不同征象分为9组,分析各组类型的FCD术后癫痫控制满意度情况。结果9组患儿中,术后癫痫控制较好的组别MRI征象为较明显局灶性灰白质分界模糊与皮质增厚,及合并Transmantle征者;术后效果较差的组MRI征象为轻度局灶性灰白质分界模糊与皮质结构变薄,及合并异常的脑沟与脑回形态者,单纯以异常的脑沟与脑回形态为主要MRI表现者术后效果明显好于伴随其它征象者,上述差异均具有统计学意义(P<0.05)。结论FCD患儿高分辨MRI具有一定特异性,从MRI征象的角度去预测术后癫痫控制的满意度具有可行性,是衡量手术预后的一项重要指标。
Objective To explore the value of high-resolution Magnetic resonance imaging(MRI)imaging in predicting the surgical effect of Focal cortical dysplasia(FCD)in children.Methods The MRI and clinical data of 143 children with FCD confirmed by surgery and pathology in Qilu Children’s Hospital of Shandong University from July2013 to July 2018 were analyzed retrospectively,and the MRI signs were analyzed,and the patients were grouped according to different signs to analyze the satisfaction of postoperative epilepsy control in each group.Results Among the 9 groups of children,MRI signs in the group with better postoperative epilepsy control were those with obvious focal gray matter blurring and cortical thickening and combined with Transmantle sign.The MRI signs in the group with poor postoperative results were mild focal gray matter blurring and cortical structure thinning,and those with abnormal sulcus and gyrus morphology,the postoperative effect of patients with only abnormal sulci and gyrus as the main MRI manifestations was significantly better than those with other signs,and the above differences were statistically significant(P<0.05).Conclusion The high-resolution MRI of children with FCD had a certain specificity,and it is feasible to predict the satisfaction of postoperative epilepsy control from the perspective of MRI signs,which is an important indicator of surgical prognosis.
作者
李林
崔若棣
杨光勇
马常友
赵建设
LI Lin;CUI Ruodi;YANG Guangyong;MA Changyou;ZHAO Jianshe(The Center of Medical Imaging,Qilu Children's Hospital of Shandong University,Jinan 250022,China)
出处
《癫痫杂志》
2021年第1期29-33,共5页
Journal of Epilepsy
基金
2018年济南市卫生和计划生育委员会科技计划(2018-1-31)。
关键词
儿童
局灶性皮质发育不良
磁共振成像
外科手术
预后
Children
Focal cortical dysplasia
Magnetic resonance imaging
Neurosurgical procedures
Prognosis
