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目的应用磁共振成像(MRI)观察儿童脑白质髓鞘发育情况,分析脑白质髓鞘化延迟患儿的临床表现及MRI表现。方法将405例脑性瘫痪及脑发育障碍患儿分为2组:≤2岁组共296例(A组);>2岁组共109例(B组)。采用同年龄段MRI T1WI和T2WI显示的正常脑髓鞘发育的标准,对每组患儿12个脑区域MRI检测结果进行评定。应用SAS9.1软件进行统计学分析。结果 A组和B组病例中,病史以HIE、早产及胆红素脑病为主,约61.5%(排除病史不祥者)。临床表现以运动发育延迟或障碍为主,约60.5%;A组最明显,约53.6%;B组约6.9%;感觉、语言、智力及精神发育障碍等,约26.2%;以抽搐为主诊断为癫或婴儿痉挛症,约13.3%。MRI影像示脑白质髓鞘化延迟A组约66.2%;B组约12.6%。结论 MRI对诊断儿童脑白质髓鞘化延迟有重要的临床意义。髓鞘化延迟可能为儿童生长发育延迟或障碍的原因之一。
Objective To observe the development of white matter myelin in children with magnetic resonance imaging (MRI) and analyze the clinical manifestations and MRI findings in children with delayed white matter myelination. Methods 405 children with cerebral palsy and brain developmental disorder were divided into two groups: 296 cases (group A) ≤2 years old and 109 cases (group B)> 2 years old. Using MRI T1WI and T2WI in the same age group to show the normal development of myelin sheath, MRI results of 12 brain regions in each group were evaluated. SAS9.1 software was used for statistical analysis. Results In group A and group B, the history was mainly HIE, premature birth and bilirubin encephalopathy, accounting for 61.5% (excluding those with history of ominous disease). The main clinical manifestations were delayed or disturbed motor development, accounting for about 60.5%; the most obvious was A group of 53.6%; B about 6.9%; sensory, language, mental and mental development disorders, about 26.2%; mainly convulsions For epilepsy or infantile spasms, about 13.3%. MRI images showed delayed white matter myelination in group A at about 66.2% and group B at about 12.6%. Conclusion MRI has important clinical significance in the diagnosis of delayed myelination in children with white matter. Delayed or delayed myelination may be one of the reasons for the growth and development of children.