脑性瘫痪并语言发育迟缓患儿语言相关功能区白质扩散张量成像研究

摘要

Objective To measure the fractional anisotropy(FA) values in the language function areas(Broca area,Wernicke area and arcuate fasciculus)by diffusion tensor imaging(DTI),discussing the pathological characteristics in cerebral palsy children with language development delay.Methods DTI was performed in twenty-seven cerebral palsy children with language development delay(observation group) and 20 children with febrile seizures(control group) by Philips 3.0T MRI scanner.The FA values of Broca area,Wernicke area and arcuate fasciculus were measured at Philips Workstation.Results The FA values of control group in the left Broca area,Wernicke area and arcuate fasciculusis were higher than those of the right side,and the difference was statistically significant (all P ＜ 0.05).The FA value of observation group in the left Broca area was lower than that of the right side,and the difference was statistically significant (P ＜ 0.05);the FA values of observation group in the left Wernick area and arcuate fasciculusis were higher than those of the right side,but the difference was not statistically significance (all P ＞ 0.05).The FA values in the bilateral Broca area and arcuate fasciculusis of observation group were lower than those of the control group,the difference was statistically significant (P ＜ 0.05),those in the bilateral Wernick area were also lower than the control group,but the difference was not statistically significant (P ＞ 0.05).Conclusions The main pathogenesis for language development delay in cerebral palsy children was extensive damage in language functional areas,and Broca area and arcuate fasciculus were markedly impaired than Wernick area.%目的 利用扩散张量成像(DTI)技术测定脑性瘫痪(脑瘫)合并语言发育迟缓患儿语言相关脑区(Broca区、Wernicke区、弓状纤维束)的各向异性参数(FA),探讨脑瘫患儿语言发育迟缓的发病机制.方法 采用Philips 3.0T磁共振仪,对27例脑瘫合并语言发育迟缓患儿(观察组)和20例热性惊厥患儿(对照组)行DTI扫描,于Philips磁共振自带工作站进行后处理,计算Broca区、Wernicke区及弓状纤维束的FA值.结果 对照组患儿左侧Broca区、Wernicke区及弓状纤维束的FA值均高于右侧,差异均有统计学意义(P均＜0.05).观察组患儿左侧Broca区的FA值低于右侧,差异有统计学意义(P＜0.05);左侧Wernicke区及弓状纤维束的FA值均高于右侧,但差异无统计学意义(P均＞0.05).观察组Broca区、Broca镜像区及两侧弓状纤维束的FA值低于对照组,差异有统计学意义(P＜ 0.05),Wernick区及Wernick镜像区的FA值也低于对照组,但差异均无统计学意义(P均＞0.05).结论 脑瘫患儿语言发育迟缓的主要发病机制为语言相关脑区的广泛性损伤,Broca区及弓状纤维束受损较Wernick区明显.