脑瘫患儿手术前后脑血流量变化的MR-ASL评价分析
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摘要
目的应用3.0T磁共振动脉自旋标记(ASL)技术对比正常儿童与行颈总动脉外膜交感神经网剥脱术前后的脑瘫患儿脑血流量(CBF)发生的变化情况差异。方法应用Achieva/Intera PHILIPS 3.0T核磁共振仪对30例正常儿童与30例行颈总动脉外膜交感神经网剥脱术前一周内、术后14天的单侧痉挛型脑性瘫痪患儿进行常规序列、DWI、ASL等序列扫描,应用Mri Cloud后处理工作站获得被检者大脑双侧额叶、颞叶、顶叶、中央前回、内囊区域、基底节、丘脑、小脑区域的CBF值,使用配对t检验对数据进行统计学分析。结果正常儿童与脑瘫患儿进行对比,脑瘫患儿患侧大脑皮质区、中央前回、基底节、内囊、小脑区运动相关区域CBF较低,差异有统计学意义;行颈总动脉外膜交感神经网剥脱术后脑瘫患儿患侧上述区域脑血流量有改善。结论通过磁共振ASL技术发现颈总动脉外膜交感神经网剥脱术是一种有效的治疗脑性瘫痪的手术方法,可以有效提高患儿脑血流量,改善大脑缺血缺氧状态,缓解患儿临床症状。
Objective Comparison of changes in cerebral blood flow(CBF) between normal children and cerebral palsy children by using arterial spin labeling(ASL), Depament of Radiology, The second Affiliated Hospital of Xinjiang medical University,before and after the cervical perivascular sympathectomy. Methods Using Achieva/Intera PHILIPS 3.0 T magnetic resonance imaging scan 30 normal children and 30 unilateral spastic cerebral palsy children who underwent cervical perivascular sympathectomy preoperative one week and postoperative 14 days in regular sequence, DWI, ASL and other sequences. The CBF value of different areas of the clients was obtained by Mri Cloud post-processing workstation, which include Bilateral of frontal lobe, the temporal lobe, the parietal lobe. Central front return,Inner sac region,The basal ganglia,The thalamus,The cerebellum were compared between two groups, A paired t-test was used for statistical analysis. ResultsIn comparison to the control group. The CBF values in the patient group decreased. There were significant differences between two groups in Cerebral cortex, anterior central gyrus, basal ganglia, inner capsule, cerebellum in the affected side,children with cerebral palsy had improved Cerebral blood flow in above areas after the cervical perivascular sympathectomy. Conclusion ASL found that cervical perivascular sympathectomy is an effective treatment of cerebral palsy surgery,And can significantly improve the CBF of children with cerebral palsy,improving cerebral ischemia and hypoxia,relieve the clinical symptoms of children.
Objective Comparison of changes in cerebral blood flow(CBF) between normal children and cerebral palsy children by using arterial spin labeling(ASL), Depament of Radiology, The second Affiliated Hospital of Xinjiang medical University,before and after the cervical perivascular sympathectomy. Methods Using Achieva/Intera PHILIPS 3.0 T magnetic resonance imaging scan 30 normal children and 30 unilateral spastic cerebral palsy children who underwent cervical perivascular sympathectomy preoperative one week and postoperative 14 days in regular sequence, DWI, ASL and other sequences. The CBF value of different areas of the clients was obtained by Mri Cloud post-processing workstation, which include Bilateral of frontal lobe, the temporal lobe, the parietal lobe. Central front return,Inner sac region,The basal ganglia,The thalamus,The cerebellum were compared between two groups, A paired t-test was used for statistical analysis. ResultsIn comparison to the control group. The CBF values in the patient group decreased. There were significant differences between two groups in Cerebral cortex, anterior central gyrus, basal ganglia, inner capsule, cerebellum in the affected side,children with cerebral palsy had improved Cerebral blood flow in above areas after the cervical perivascular sympathectomy. Conclusion ASL found that cervical perivascular sympathectomy is an effective treatment of cerebral palsy surgery,And can significantly improve the CBF of children with cerebral palsy,improving cerebral ischemia and hypoxia,relieve the clinical symptoms of children.
引文
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[3]王斌,周茜,姚振威,等.CT灌注与MR灌注加权成像对烟雾病血管重建术疗效的评价[J].中国医学计算机成像杂志,2015,21(1):64-68.
[4]苗娜,齐建国,周全红,等.3D动脉自旋标记成像在神经胶质瘤术前分级中的应用价值[J].中国CT和MRI杂志,2017,15(1):11-13.
[5]Noguchi T,Kawashima M,Nishihara M,et al.Noninvasive method for mapping CVR in moyamoya disease using ASL-MRI[J].European Journal of Radiology,2015,84(6):1 1 37.
[6]Koy A,Pauls K A M,Flossdorf P,et al.Young Adults with Dyskinetic Cerebral Palsy Improve Subjectively on Pallidal Stimulation,but not in Formal Dystonia,Gait,Speech and Swallowing Testing[J].European Neurology,2014,72(5-6):340.
[7]李爱民,于炎冰,张黎.颈动脉外膜交感神经切除术在神经外科的应用[J].中华神经外科疾病研究杂志,2012,11(3):278-280.
[8]俞梦瑾,黄平兰,叶瑞雄,等.颈动脉交感神经网剥离术结合选择性脊神经后根切断术治疗脑性瘫痪肌痉孪:11例报道[J].中国康复理论与实践,2014,20(2):167-170.
[9]陈传亮,白岩,王梅云,等.三维伪连续性动脉自旋标记磁共振灌注成像联合扩散加权成像在脑胶质瘤分级中的价值[J].中国医学计算机成像杂志,2015,21(5):426-430.
[10]Yamamoto T,Takeuchi H,Kinoshita K,et al.Assessment of tumor blood flow and its correlation with histopathologic features in skull base meningiomas and schwannomas by using pseudocontinuous arterial spin labeling images[J].European Journal of Radiology,2014,83(5):817-823.
[11]Englander Z A,Sun J,Case L,etal.Brain structural connectivity increases concurrent with functional improvement:evidence from diffusion tensor MR I in children with cerebral palsy during therapy[J].Neuroimage Clin,2015,7:315-324.
[12]郭慧敏,杨晓光,王泽峰.3.0T场强磁共振应用MRA血管成像与3D-ASL脑灌注成像技术在诊断缺血性脑血管疾病中的应用[J].中国CT和MRI杂志,2016,14(12):35-36.
[13]徐亚利,袁瑛,陶晓峰,等.ASL在不同年龄段正常人脑血流量中的应用[J].实用放射学杂志,2014(8):1267-1270.