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目的通过头颅磁共振弥散张量成像技术(DTI)并结合脑性瘫痪(CP)患儿粗大运动评估(GMFM)的测定来探讨其对脑瘫患儿运动功能转归的应用价值。方法选取痉挛型脑瘫患儿65例作为研究组,正常儿童16例作为对照组,应用GMFM评价患儿粗大运动功能。对受试儿童进行DTI检查,测量各组患儿主要白质纤维束部分各向异性(FA)。结果各个部位的FA值与GMFM-88值存在正相关性,均存在统计学意义,其中内囊后肢相关性明显(r=0.455)。结论粗大运动功能障碍与脑内广泛白质纤维束损伤有关,以内囊后肢部位最明显。FA值的高低一定程度上反映运动功能的发育情况,DTI在评价痉挛性脑瘫运动功能方面有较高的应用价值。
Objective To investigate the value of gross motor evaluation (GMFM) in children with cerebral palsy by using magnetic resonance diffusion tensor imaging (DTI) combined with the measurement of GMFM in children with cerebral palsy. Methods Sixty-five children with spastic cerebral palsy were selected as the study group and 16 normal children as the control group. GMFM was used to evaluate the gross motor function in children. The subjects were examined by DTI to measure the partial anisotropy (FA) of the major white matter fiber bundles in each group. Results There was a positive correlation between FA values and GMFM-88 values in all the groups. There was a significant difference between the two groups (r = 0.455). Conclusions The gross motor dysfunction is related to extensive white matter injury in the brain, with the most obvious hindlimb location in the inner capsule. FA value to some extent reflect the development of motor function, DTI in the evaluation of spastic cerebral palsy motor function has a higher value.