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目的利用CT图像,分析脑性瘫痪患儿脑白质数量减少程度,并对脑白质数量减少进行模糊判据分析。方法选择1～3岁临床诊断为脑性瘫痪病例,根据CT检查结果筛选出未见异常、脑白质偏少、脑室旁脑白质软化(PVL)3类病例。将这3类病例,依照年龄每3个月分为一小组,每一小组随机选取6例,共分为24个小组,共144例。利用CT工作站软件测量每例患儿半卵圆层面的脑白质和大脑半球的面积并进行统计分析;根据脑白质面积与大脑半球面积的比值对脑白质减少的性质进行疾病隶属度的模糊判据。结果 1.未见异常组、脑白质偏少组和PVL组患儿脑白质面积数量的中位数依次为2 000 mm2、1 738 mm2和1 387 mm2,未见异常组与脑白质偏少组、PVL组之间的差异均有统计学意义(P<0.05,0.01);脑白质偏少组与PVL组间差异无统计学意义(P>0.05)。2.大脑半球面积的中位数分别为5 809 mm2、5 618 mm2和5 370 mm2,3组间的差异均无统计学意义(Pa>0.05)。3.脑白质数量的隶属度图显示脑白质偏少组与PVL组、未见异常组均有交集,但是与PVL组有更多交集;当脑白质与大脑半球的面积比值<0.255时,患儿属于PVL的隶属度≥0.5。结论影像科诊断医师对脑白质数量的评估较为准确;脑白质偏少可视为轻度PVL。计算半卵圆脑白质与大脑半球的面积比值并由此确认脑白质减少的隶属度对确认病情的严重程度有参考意义。
Objective To analyze the degree of white matter reduction in children with cerebral palsy by using CT images and to analyze the fuzzy criterion of white matter reduction. Methods One to three years old were selected as the cases of cerebral palsy. According to the results of CT examination, three cases of no abnormalities, less white matter and less periventricular leukomalacia (PVL) were screened out. The three cases were divided into small groups according to their age every three months. Each group was randomly selected from 6 patients and divided into 24 groups, a total of 144 cases. The areas of white matter and hemispheres in the semi-oval layer of each child were measured by CT workstation software and statistically analyzed. According to the ratio of the area of white matter to the area of hemisphere, the fuzzy membership of the disease was evaluated. . No abnormal group, the white matter less white group and PVL group, the median number of children with white matter followed by 2 000 mm2, 1 738 mm2 and 1 387 mm2, no abnormal group and less white matter group , PVL group (P <0.05, 0.01). There was no significant difference between PVL group and PVL group (P> 0.05). The median hemispheric area was 5 809 mm2,5 618 mm2 and 5 370 mm2, respectively. There was no significant difference between the three groups (Pa> 0.05). 3. The membership of white matter in the white matter showed that the group with less white matter and PVL group had no intersection, but there was more intersection with PVL group. When the area ratio of white matter and cerebral hemisphere <0.255, Children belonging to PVL membership degree ≥ 0.5. Conclusion Imaging physicians diagnosed the white matter quantity is more accurate assessment; less white matter can be considered mild PVL. Calculate the ratio of the area of the half oval white matter to the area of the cerebral hemispheres and thus confirm the membership of white matter reduction for reference to determine the severity of the disease.