Hou Mei, Fan Xi-wen, Li Yu-tang, Yu Rong, Guo Hong-lei
Qingdao Chilren's Hospital, The Rehabilitation Center For Disabled Children, Qingdao 266011, China.
Zhonghua Er Ke Za Zhi. 2004 Feb;42(2):125-8.
To study the clinical and neurological abnormalities in children with cerebral palsy (CP) and to attempt to correlate the types of CP and the gestational age at birth with radiological abnormalities detected by magnetic resonance imaging (MRI) of the brain.
This is a hospital-based study, the subjects included 104 children with cerebral palsy who were hospitalized in the Qingdao Rehibilitation Center For Disabled Children. All the 104 hospitalized CP cases (47 with spastic diplegia, 9 with tetraplegia, 15 with hemiplegia, 22 with athetosis, and 11 with ataxia) were examined neurologically and their perinatal history was reviewed. Their cranial MRI findings were studied. The association between the gestational ages, CP types, and the radiological findings were studied.
The type distribution was significantly different between term- and preterm- infants. Spastic diplegia was the main type in preterm infants while hemiplegia and ataxia were mainly seen in term infants. MRI abnormalities were found in 88 of the 104 cases and abnormal rates of spastic diplegia, tetraplegia, hemiplegia, athetosis, and ataxia were 89.4%, 100%, 100%, 54.5% and 90.9%, respectively. There was no significant difference in abnormal rates between term and preterm groups. Thirty-one of 42 (73.8%) children with spastic diplegia had significant periventricular leukomalacia (PVL), which was more common among preterm-born children (90%). Of the 15 children with hemiplegia, 13 had unilateral lesions on neuroimaging. Spastic tetraplegia was associated with extensive, bilateral, diffuse brain damage. The abnormalities in term-born infants with athetoid cerebral palsy were mainly located in the basal ganglia region whereas the major abnormality in premature infants was PVL. Of the 11 children with ataxic cerebral palsy, 8 cases showed congenital cerebellum dysplasia on brain imaging.
Radiological abnormalities of the brain were correlated with CP types and the gestational age at birth; MRI scan was useful in revealing underlying brain abnormalities and speculating on the etiology of cerebral palsy.
研究脑瘫（CP）患儿的临床及神经学异常情况，并尝试将CP类型及出生孕周与脑部磁共振成像（MRI）检测到的放射学异常相关联。
这是一项基于医院的研究，研究对象包括在青岛市残疾儿童康复中心住院的104例脑瘫患儿。对全部104例住院的CP病例（痉挛型双瘫47例、四肢瘫9例、偏瘫15例、手足徐动型22例、共济失调型11例）进行了神经学检查，并回顾了其围产期病史。研究了他们的头颅MRI表现。研究了孕周、CP类型与放射学表现之间的关联。
足月儿和早产儿的类型分布存在显著差异。痉挛型双瘫是早产儿的主要类型，而偏瘫和共济失调型主要见于足月儿。104例病例中有88例发现MRI异常，痉挛型双瘫、四肢瘫、偏瘫、手足徐动型和共济失调型的异常率分别为89.4%、100%、100%、54.5%和90.9%。足月儿组和早产儿组的异常率无显著差异。42例痉挛型双瘫患儿中有31例（73.8%）有显著的脑室周围白质软化（PVL），在早产儿中更常见（90%）。15例偏瘫患儿中，13例在神经影像学上有单侧病变。痉挛型四肢瘫与广泛的、双侧的、弥漫性脑损伤有关。手足徐动型脑瘫足月儿的异常主要位于基底节区，而早产儿的主要异常是PVL。11例共济失调型脑瘫患儿中，8例在脑部影像学上显示先天性小脑发育不良。
脑部放射学异常与CP类型及出生孕周相关；MRI扫描有助于揭示潜在的脑部异常并推测脑瘫的病因。
