文献汇报-脑瘫-影响完整版

1、2/10ContentsIntroduction Results and discussion Conclusions Experimental section3/10ContentsIntroduction Results and discussion Conclusions Experimental section4/10 With regard to CP 小儿脑发育过程中各种原因引起的脑损伤，表现为非进行性、中枢性运动功能障碍5/10 脑瘫早期的肢体功能障碍不明显, 早期诊断、分型不容易 With regard to CP 6/10 With regard to DTI DTI 是一种

2、新近应用于临床的具有无创伤性优点的新的成像方法, 其可以定量分析大脑的微细结构，观察大脑的发育7/10 With regard to DTI 有时传统的MRI不能描述大脑特定部位的病理变化，DTI却可以对大脑病理改变进行定位和量化。8/10观察指标观察指标 MD:MD: 平均弥散率. 可以定量的反映脑组织中水分子的平均扩散速度 FA:FA: 部分各向异性指数。 扩散的方向性 脑各部位的MD值随年龄的增长而减低，FA值随年龄的增长而增高 两者结合可以更好的反映脑髓鞘的发育情况 9/10 Purpose 利用DTI评价手足徐动型脑瘫及痉挛型脑瘫患儿深部灰质和白质的解剖结构，并探讨不同类型脑瘫患儿的

3、解剖学变化是否与其诊断、预后具有相关性10/10ContentsIntroduction Results and discussion Conclusions Experimental section11/10Study subjects(研究对象)athetotic CPathetotic CPspastic CPspastic CPhealthy control subjectshealthy control subjectsnumbernumber19（42%）26（58%）31（%）boysboys13（68%）19（73%）16（52%）girlsgirls6（32%）7（27%）1

4、5（48%）age rangeage range10months12years6months15years8months13yearsmean agemean age3.4years3.3years3.2yearsmedian agemedian age2years2years2yearspreterm childrenpreterm children9（47%）24（92%）1（3%）term childrenterm children10（53%）2（8%）30（97%）mean gestational agemean gestational age35weeks5.4（2341weeks

5、）32weeks3.7（2540weeks）39weeks1.5（3641weeks）mean gestational weightmean gestational weight2374g954g（6203620g）1871g579g （7742970g）2987g591g（21404552g）12/10conventional MR imagingDT imagingb value=0,500,1000s/mm2 b value=500s/mm2section thickness 5mm section thickness 3mmFOV 220*220mmFOV 220*220mmmatri

6、x 256*256repetition time 57005900msecho time 102msClinical pulse sequencesMR imaging Protocols(扫描方法)13/10Postprocessing(图像处理)Postprocessing was performed by using DtiStudio software and DiffeoMap software. ROIS(兴趣区): deep gray matterPutamen 壳核壳核globus pallidus 苍白球苍白球Thalamus 丘脑丘脑white matter structu

7、resprojection fibers 投射纤维投射纤维association fibers 联络纤维联络纤维commissural fibers 连合纤维连合纤维Calculated FA & MD 14/10Data Analysis(统计学分析) Microsoft Excel 2007 for Windows software Stata, version 1 0.0, software variance group tests with post hoc Scheffe multiple comparison tests.(方差分析&多个均数的两两事后比较) nonparametr

8、ic Kruskal-Wallis test with Bonferroni correcti-on(Bonferroni校正的秩和检验 )Demographic data(研究对象一般资料)FA MD15/10ContentsIntroduction Results and discussion Conclusions Experimental section16/10Demographic data(研究对象一般资料)Results(结果) Age： no significan difference between the three group Gestational week & we

9、ight： no significant difference between athetotic CP and spastic CP or between athetotic CP and the control group17/10深部灰质深部灰质白质白质壳核壳核苍白球苍白球丘脑丘脑内囊后肢内囊后肢丘脑后辐射丘脑后辐射上纵束上纵束胼底体胼底体18/10白质白质深部灰质深部灰质壳核壳核苍白球苍白球丘脑丘脑丘脑后辐射丘脑后辐射上纵束上纵束胼底体胼底体19/1020/10 在手足徐动型脑瘫患儿的深部灰质和白质的多个脑区中，FA值均显著低于对照组和痉挛型脑瘫患儿（P0.05，P=0.0001)并且伴有MD值升高（P0.05，P0.0001）Results(结果) 21/10 另一方面,痉挛型脑瘫患儿部分白质区域的FA值也显著低于正常对照者 （P0.05，P=0.0001）Results(结果) 22/10ContentsIntroduction Results and discussion C