儿童结节性硬化症脑白质磁共振弥散加权成像及.doc

儿童结节性硬化症脑白质磁共振弥散加权成像及ADC值测量 高雅丽1，蔡金华1，程敏2（400014 重庆，重庆医科大学附属儿童医院：放射科1，神经内科2） [摘要] 目的 探讨结节性硬化症（TSC）儿童与正常儿童脑白质磁共振表观弥散系数（ADC）值差异以及TSC儿童脑白质ADC值与临床相关性。方法 回顾性分析52例经临床确诊的TSC的MRI图像，按年龄分组，测量脑白质ADC值，并与一组年龄相匹配的正常儿童对照；同时按照临床有无癫痫、智力障碍或孤独症对病情严重程度进行评分，分析病情严重程度与ADC值之间的相关性。结果 各年龄组TSC患者额、顶、枕、颞叶及小脑白质ADC值均高于对照组脑白质ADC值，其中除1岁～3岁年龄组颞叶和小脑以及12.1岁～18岁组小脑外，其余各年龄组各部位脑白质ADC值均与对照组有显著差异(p0.05)。大脑各部位脑白质ADC值增加与临床病情严重程度之间存在显著相关性（p0.05）。 结论 TSC儿童脑白质ADC值升高，反映了脑白质髓鞘破坏或发育障碍，可能是TSC临床出现认知障碍的主要基础。 [关键词] 结节性硬化症；儿童；脑白质；表观弥散系数 [中图法分类号] R445.2 [文献标识码]　A MR diffusion-weighted imaging and ADC value measurement in the white matter of children with tuberous sclerosis complex. Gao Yali1, Cai Jinhua1，Cheng Min2 (1Department of Radiology, 2Department of Neurology，Children’s Hospital of Chongqing Medical University, Chongqing 400014, China) [Abstract] Objective To compare the apparent diffusion coeffecient (ADC) values of the white matter in children suffered from tuberous sclerosis complex (TSC) with those in healthy controls, and explore the association of ADC values with the severity of neurological symptoms. Methods Fifty-two cases of clinically confirmed TSC who underwent diffusion weighted imaging were included in this study. The ADC values were measured in the frontal, parietal, occipital, temporal and cerebellar white matter, and compared with those in age-matched healthy controls. According to the presence of epilepsy, mental retardation, or autism, the neurological severity scoring was conducted, and correlated with the ADC values. Results ADC values of the white matter were higher in TSC patients compared with the healthy controls. The increase of ADC values reached statistical significance in all regions and all age groups (p0.05), except for the temporal and cerebellar white matter in the age group between 1 and 3 years, and the cerebellar white matter in the age group between 12.1 and 18 years. There was a significant correlation between the ADC values increase and the neurological