目的：探讨白质纤维束成像（DTT ）技术在分析皮质脊髓束（CST ）损伤在偏瘫患儿童粗大功能影响中的应用价值。方法对24例偏瘫型脑瘫患儿进行扩散张量成像及 DTT ，测量健侧和患侧 CST 的各项异性分数（FA）值和表观弥散系数（ADC）值。评估 CST 的移位、连续性及损伤情况；并评估患儿的粗大运动功能（GMFM ），分析 CST 损伤程度与偏瘫型脑瘫患儿预后的相关性。结果软化灶与 CST 的关系分3级，CST1级，FA 值降低，ADC 轻度增高（P ＞0.05）；CST2级和3级， FA 值明显降低，ADC 明显增高（P ＜0.05）；患儿 CST 分级越高，GM FM 值越低，患儿的预后越差。结论 DTT 可以显示CST 与软化灶的损伤关系，并能对偏瘫型脑瘫患儿的预后作出评价。%Objective To investigate the application effect of diffusion tensor tractography (DTT) on injured corticospinal tract (CST ) in children with hemiplegic cerebral palsy. Methods Twenty‐four children with hemiplegic cerebral palsy received DTT examination ,and then FA value ,ADC value were measured in uninjured side and affected side. Transposition ,continuity and injured degree of CST and gross motor function measure (GMFM ) were evaluated. Finally ,we analyzed the correlation be‐tween severity of injured CST and prognosis. Results The relationship between encephalomalacia foci and injured CST was classified into three levels. Level 1 CST had the characteristics of reduced FA value and slightly increased ADC value (P <0.05). Similarly ,level 2 and level 3 CST were accompanied with obvious decrease of FA value and huge increase of ADC value (P< 0.05). With the higher CST level and the lower GMFM value ,children could have the worse clinical prognosis. There was a significant negative correlation between the severity of injured CST and GMFM value (r= - 0.923 ,P< 0.05). Conclu‐sion DTT can reveal relation between injured CST and encephlomalacia foci ,which can evaluate the prognosis in children with hemiplegic cerebral palsy.
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