目的：应用3.0T磁共振动脉自旋标记（Arterial spin labeling，ASL）技术研究脑瘫患儿行颈总动脉外膜交感神经网剥脱术前后脑血流量（Cerebral blood flow，CBF）发生的变化情况。方法：收集50例痉挛型单侧脑性瘫痪患者，于手术前后应用Achieva/Intera Philips 3.0T核磁共振仪对患儿进行常规序列及DWI、ASL等序列扫描，应用MriCloud后处理工作站获得患儿大脑双侧额叶、颞叶、顶叶、内囊区域的CBF值，使用配对t检验对数据进行相关性分析。结果：在行手术前，患侧与正常侧对比，患侧中央前回、小脑、基底节、内囊运动相关区域CBF降低；手术后患侧等区域较对侧的CBF有改善，差异有统计学意义，丘脑区CBF差异无统计学意义。与术前相比，手术后内囊区、小脑等区域的CBF明显大于术前，差异有统计学意义，大脑皮质区、基底节区CBF较术前有所增加，但差异无统计学意义；术后丘脑区CBF较术前无明显改善。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CBF，改善大脑缺血缺氧状态，缓解患儿的临床症状。
Abstract
Objective: To study the changes of cerebral blood flow(CBF) in children with cerebral palsy before and after common carotid artery adventitial sympathetic nerve net denudation using 3.0T magnetic resonance arterial spin labeling(ASL) technique. Methods: Before and after the operation, 50 patients with spastic unilateral cerebral palsy underwent conventional MRI, DWI, ASL scanning using Philips Achieva/Intera 3.0T MR. The CBF values in bilateral frontal lobe, temporal lobe, parietal lobe and internal capsule area were obtained by MriCloud post-processing workstation. Correlation analysis was performed by paired t test. Results: Before operation, compared with the normal side, the CBF of the affected side in the precentral gyrus, cerebellum, basal ganglia and internal capsule decreased. After operation, compared with the normal side, the cerebral blood flow of the part areas of the affected side was improved, the difference was statistically significant, thalamus cerebral blood flow had no significant difference. After operation, the CBF in the internal capsule area and cerebellum was significantly higher than that before surgery, the difference was statistically significant, the CBF in the cerebral cortex and basal ganglia increased compared with that before operation, but the difference was not statistically significant, the CBF in thalamus was not significantly improved compared with that before operation. Conclusion: The magnetic resonance ASL technology can proved that carotid artery sympathetic nerve net stripping surgery is an effective surgical treatment for cerebral palsy, the operation can effectively improve the CBF, improve cerebral ischemia and hypoxia, and relieve the clinical symptoms.
关键词
脑性瘫痪 /
磁共振成像
Key words
Cerebral palsy /
Magnetic resonance imaging
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