摘要
目的探究磁共振扩散张量成像(DTI)技术对行颈总动脉交感神经网剥脱术治疗后的成人脑性瘫痪患者脑白质恢复情况的评估价值。方法选取2016年10月至2018年10月在本院行颈总动脉交感神经网剥脱术治疗的80例单侧痉挛型脑瘫患者为研究对象,评估患者术前和术后6个月粗大运动功能分级系统(gross motor function classification system,GMFCS)分级情况、DTI内囊后肢和大脑脚的各向异性分数(fractional anisotropy,FA)及其相关性。结果(1)与术前相比,患者在行颈总动脉交感神经网切除术6个月后,粗大运动功能评分提高,分级情况有所改善,差异有统计学意义(P=0.005);(2)患者术后6个月术侧内囊后肢FA值为(0.478±0.081),显著高于术前(0.426±0.069),差异有统计学意义(P<0.001);术后6个月术侧大脑脚FA值为(0.443±0.079),显著高于术前(0.361±0.081),差异具有统计学意义(P<0.001);(3)术后6个月患者GMFCS分级与内囊后肢FA值呈负相关(r=-0.620,P<0.01),与大脑脚FA值也呈负相关(r=--0.719,P<0.01)。结论DTI技术对评估行颈总动脉交感神经网剥脱术治疗的成人脑瘫患者术后脑白质恢复情况具有重要价值,值得临床推广应用。
Objective To investigate the value of diffusion tensor imaging(DTI)in the evaluation of postoperative white matter recovery after cervical perivascular sympathectomy in adult patients with cerebral palsy.Methods Eighty patients with cerebral palsy were underwent cervical perivascular sympathectomy.Evaluate the grade of gross motor function classification system(GMFCS)and the fractional anisotropy(FA)of the hind limbs and cerebral peduncle before and after surgery.Results(1)After the treatment of cervical perivascular sympathectomy,the symptoms of 80 patients with cerebral palsy were improved.The difference is statistically significant(P=0.005);(2)The FA value of the hindlimb in the surgical side of the patient was(0.478±0.081)at 6 months after operation,which was significantly higher than that before surgery(0.426±0.069).The difference was statistically significant(P<0.001);6 months after operation The FA value of the cerebral peduncle was(0.443±0.079),which was significantly higher than that before surgery(0.361±0.081),and the difference was statistically significant(P<0.001);(3)The GMFCS grade was negatively correlated with the FA value of the posterior limb of the internal capsule at 6 months after operation(r=-0.620,P<0.01),and negatively correlated with the FA value of the brain(r=--0.719,P<0.01).Conclusion DTI technology is of great value in the evaluation of postoperative white matter recovery in adult patients with cerebral palsy treated by cervical perivascular sympathectomy.It is worthy of clinical application.
作者
努尔比亚·艾海提
金海燕
古次里娜·托汗
何俐
栾新平
Nuerbiya·Aihaiti;Jin Haiyan;Gucilina·Tuohan;He Li;Luan Xinping(Department of Neurology,the Second People's Hospital of Kashgar,Xinjiang 844000,China)
出处
《脑与神经疾病杂志》
2020年第8期503-507,共5页
Journal of Brain and Nervous Diseases
基金
国家自然科学基金委员会资助项目(81660202)
作者简介
通信作者:古次里娜·托汗,Email:nlposkjj@163.com
