足月儿早产儿痉挛型脑性瘫痪CT的对比研究

Comparison of brain CT findings of children with spastic cerebral palsy, born premature and at term

摘要:

目的：研究足月儿与早产儿痉挛型脑性瘫痪的CT表现。方法：回顾性分析88例痉挛型脑性瘫痪患儿CT表现,分早产儿和足月儿两组分析,其中46例足月儿,42例早产儿。结果：88例痉挛型脑性瘫痪患儿CT表现的阳性率78.4%(69/88)。主要是脑室周围白质软化(PVL)后遗改变,为47/88例,其中足月儿17例,早产儿30例,两组差异有显著性意义(P<0.05);PVL白质减少可发生于侧脑室体中前部、侧脑室体后部、侧脑室三角区、半卵圆中心,两组间白质减少和侧脑室扩大部位差异无显著性意义;而侧脑室形态不规则扩大在早产儿30例中有7例,足月儿侧脑室扩大未见不规则改变,两组差异有显著性意义(P<0.05)。结论：痉挛型脑性瘫痪CT主要表现为PVL后遗改变,早产儿出现PVL和重度PVL的概率明显大于足月儿。

Abstract:

OBJECTIVE: To study the brain CT findings in premature and term birth children with spastic cerebral palsy. METHODS: Brain CT findings in 88 children (aged 2 months to 7 years) with spastic cerebral palsy were analyzed retrospectively. Of the 88 subjects, 46 cases born preterm and 42, at term. RESULTS: Brain CT showed that abnormal intracranial findings in 69 of 88 cases, many presenting with periventricular leukomalacia(PVL).PVL occurred in 30 preterm patients and in 17 term patients. The incidence of PVL in premature birth patients was significantly higher than that in term birth patients (P<0.05). Seven out of 30 premature birth patients with PVL presented with lateral ventricular enlargement with irregular appearance but none of term birth patients did. The locus of lateral ventricular enlargement and white matter reduction was not different between premature and term birth patients. CONCLUSIONS: PVL seen in brain CT was the main presentation in spastic cerebral palsy. The incidence of PVL in premature birth patients was higher than that in term birth patients and PVL was more severe in premature birth patients.