弥散张量成像对脑室周围白质软化患儿术后脑白质恢复的评估作用

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(P0.05)。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(P0.05),且与对照组之间的差异无统计学意义(P0.05)。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。

Effect of Diffusion Tensor Imaging on Evaluating the Postoperative Cerebral White Matter Recovery in Children with Periventricular Leukomalacia

Objective:To study the value of diffusion tensor imaging (DTI) on evaluating the cerebral white matter recovery in children with periventricular leukomalacia (PVL) after selective posterior rhizotomy (SPR).Methods:40 PVL children who were treated with SPR in Cerebral Palsy Center of Second Affiliated Hospital of Xinjiang Medical University fromJanuary 2014 to August 2015 were selected as the observation group, 40 cases of normal children who were treated with MRI were selected as the control group during the same period. Patients of two groups were treated with DTI examination before and after operation. The fractional anisotropy (FA) value and apparent diffusion coefficient (ADC) value of different parts in two groups were compared.Results:The FA values of different parts in observation group were slightly lower than that of the control group, the ADC value of the corpus callosum in the observation group was slightly higher than that of the control group, the differences were statistically significant(P<0.05); The FA values of different parts of the observation group after operation were slightly higher than that before operation, the ADC value of the corpus callosum after operation was slightly lower than that before operation, the differences were statistically significant(P<0.05), and there was no significant difference between the observation group and the control group (P>0.05).Conclusion:SPR can obviously control the condition of children with PVL, and the use of DTI imaging technology can objectively reflect in the recovery of cerebral white matter of children with PVL who were treated with SPR, which plays an important role in the clinical treatment and prognosis evaluation.