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目的:研究弥散张量成像(DTI)对脑室周围白质软化(PVL)患儿选择性脊神经后根切除术(SPR)后脑白质恢复的评估价值。方法:选取从2014年1月至2015年8月在新疆医科大学二附院脑瘫中心择期行SPR手术治疗的PVL患儿40例作为观察组,另选同期磁共振成像(MRI)检查正常儿童40例作为对照组,两组分别在手术前后进行DTI检查,比较两组不同部位的部分各向异性值(FA)及表观弥散系数(ADC)。结果:术前观察组不同部位的FA值均显著低于对照组,胼胝体压部的ADC值显著高于对照组,差异均有统计学意义(P<0.05)。与术前比较,术后观察组不同部位的FA值均上升,胼胝体压部的ADC值下降,差异均有统计学意义(P<0.05),且与对照组之间的差异无统计学意义(P>0.05)。结论:SPR术能够明显控制PVL患儿的病情,且采用DTI成像技术能够客观地反应PVL患儿SPR术后脑白质恢复情况,对辅助临床治疗和预后评估具有重要作用。
Objective: To evaluate the value of diffusion tensor imaging (DTI) in the evaluation of white matter recovery after selective posterior rhizotomy (SPR) in children with periventricular leukomalacia (PVL). Methods: From January 2014 to August 2015, 40 children with PVL undergoing SPR at the Cerebral Palsy Center of the Second Affiliated Hospital of Xinjiang Medical University were enrolled as the observation group, while the other 36 cases of normal children under the same magnetic resonance imaging (MRI) Cases as a control group, two groups were performed before and after DTI examination, partial anisotropy (FA) and apparent diffusion coefficient (ADC) were compared between two groups. Results: The FA values in different parts of the preoperative observation group were significantly lower than those in the control group. The ADC value of the corpus callosum was significantly higher than that of the control group (P <0.05). Compared with the preoperative values, the FA values in different parts of postoperative observation group increased, and the ADC value of corpus callosum pressure decreased, the difference was statistically significant (P <0.05), and there was no significant difference with the control group P> 0.05). CONCLUSIONS: SPR can obviously control the condition of children with PVL, and DTI imaging can objectively reflect the recovery of white matter after SPR in children with PVL, which plays an important role in adjuvant clinical treatment and prognosis evaluation.