CT和MR對小兒腦性癱瘓診斷中的效果研究

張洪濤

[摘要] 目的 對CT和MR在小兒腦性癱瘓診斷中的臨床應用價值進行分析和探究。方法 方便選擇該院在2016年6月—2018年12月期間收治的80例小兒腦性癱瘓患者作為該次研究納入的對象，回顧性分析其臨床資料，將該次研究的患兒按照病歷單雙號將其隨機劃分為對照組和觀察組，每組各有40例。采用CT檢查的方式檢查對照組患兒，采用MR檢查的方式檢查觀察組患兒，對兩組患兒的診斷準確率進行分析和比較。結果 對照組患兒檢查出3例腦缺血，2例腦白質異常，4例腦膜炎，4例腦部發育不良，2例腦軟化以及5例腦部積水，共計達到了50.0%的陽性診斷率;觀察組患兒檢查出8例腦缺血，4例腦白質異常，7例腦膜炎，7例腦部發育不良，4例腦軟化以及8例腦部積水，共計達到了95.0%的陽性診斷率。觀察組的陽性率明顯高于對照組患兒，兩組相比差異有統計學意義（χ2=17.855，P<0.05） 。兩組患兒的致病原因為產傷、缺血缺氧、腦先天發育不良;在檢查陽性的58例患兒的影像中，致病原因為產傷的患兒共計11例，在CT和MR影像中具有腦膜炎（4例）和腦炎（7例）的影像特征;致病原因為缺血缺氧的患兒共計33例，在CT和MR影像中具有腦積水（11例）、腦灰白質萎縮（1例）、腦白質變性（3例）、腦缺血灶（11例）、腦軟化灶（5例）、雙側額部硬膜下積液（2例）的影像特征;致病原因為腦先天發育不良的患兒共計14例在CT和MR影像中具有腦灰白質移位（2例）、腦裂畸形（1例）、無腦匯（2例）、巨腦匯畸形（2例）、胼胝體發育不良（3例）、腦貫通性畸形（1例）、腦軟化灶（1例）和腦多發鈣化斑（2例）的影像特征。結論 與CT相比，MR在小兒腦性癱瘓的臨床診斷中具有更高的陽性診斷率，應用價值更高。

[關鍵詞] CT;MR;小兒腦性癱瘓;臨床診斷;陽性診斷率;效果

[中圖分類號] R730.41 ? ? ? ? ?[文獻標識碼] A ? ? ? ? ?[文章編號] 1674-0742（2020）02（a）-0186-03

Effect of CT and MR on the Diagnosis of Cerebral Palsy in Children

ZHANG Hong-tao

Department of Imaging， Liangshan County People's Hospital， Liangshan， Shandong Province， 272600 China

[Abstract] Objective To analyze and explore the clinical application value of CT and MR in the diagnosis of cerebral palsy in children. Methods Convenient selection of eighty children with cerebral palsy admitted to the hospital from June 2016 to December 2018 were enrolled as the subjects of this study. The clinical data were retrospectively analyzed. The children in this study were selected according to their medical records. The number was randomly divided into a control group and an observation group， with 40 cases in each group. The children in the control group were examined by CT examination. The children in the observation group were examined by MR examination. The diagnostic accuracy of the two groups was analyzed and compared. Results In the control group， 3 cases of cerebral ischemia， 2 cases of abnormal white matter， 4 cases of meningitis， 4 cases of brain dysplasia， 2 cases of encephalomalacia and 5 cases of hydrocephalus were detected， with a positive diagnosis rate of 50.0%. In the observation group， there were 8 cases of cerebral ischemia， 4 cases of abnormal white matter， 7 cases of meningitis， 7 cases of brain dysplasia， 4 cases of cerebral softening and 8 cases of hydrocephalus， which reached a positive diagnosis rate of 95.0%. The positive rate in the observation group was significantly higher than that in the control group， and the difference between the two groups was statistically significant（χ2=17.855， P<0.05） . The pathogenic causes of the two groups of children were birth injury， ischemia and hypoxia， and brain congenital dysplasia. Among the 58 positive cases， a total of 11 cases were caused by birth injury. The CT and MR images showed the imaging characteristics of meningitis （4 cases） and encephalitis （7 cases）. A total of 33 children were diagnosed with hypoxia and ischemia， and the CT and MR images showed hydrocephalus （11 cases）， atrophy of gray matter （1 case）， degeneration of white matter （3 cases）， cerebral ischemia （11 cases）， cerebral softening （5 cases） and bilateral subdural effusion （2 cases）. Causes of congenital dysplasia with a total of 14 cases in CT and MR imaging of brain gray matter translocation （2 cases）， split brain malformation （1 case）， no brain （2 cases）， giant brain malformation （2 cases）， corpus callosum dysplasia （3 cases） and brain malformation （1 case）， encephalomalacia foci （1 case） and brain imaging features of multiple calcified plaque （2 cases）. Conclusion Compared with CT， MR has a higher positive diagnosis rate in the clinical diagnosis of cerebral palsy in children， and its application value is higher.