Application Value Of Dynamic Magnetic Resonance Diffusion Tensor Imaging In Nurseling Spastic Cerebral Palsy

Objective To explore the application value of magnetic resonance diffusion tensor imaging(DTI)in nurseling spastic cerebral palsy.Methods Accorded to the age,as a study group,thirty-three with spastic cerebral palsy firstly diagnosed in Anhui Provincial Children’s Hospital from January 2016 to December 2017 were divided into two groups: 0 to 1 years old of A group and 1-3 years old of B group;As a control group,thirty-three normal children matched with the age of the study group,were divided into two groups: 0 to 1 years old of C group and 1-3 years old of D group.All children were examined for craniocerebral magnetic resonance and diffuse tensor imaging.ICAL,ICGL,ICPL,GCC,SCC,caudex cerebri CST were selected as region of interest(ROI)to get fractional anisotropy(FA value),group-samples t test was used to compare the FA value of each region of interest in the study group and the control group.In the study group,88 assessments of gross motor function measure(GMFM-88)were performed before treatment,after one-year comprehensive rehabilitation in our hospital reviewed MRI plain scan,DTI examination and GMFM-88 assessment,paired samples t test was used to compare the FA values before and after treatment;the total score of GMFM-88 before and after treatment in the study group was compared by paired samples t test;Spearman correlation analysis was used to study the correlation between the FA growth value and the growth of GMFM-88 total score in the white matter fiber bundles of different parts of the brain,to explore the value of DTI for assessing children with cerebral injury and motor function.Results(1)The MRI scan of the study group was abnormal.The MRI scan of the control group showed no obvious abnormality,there was no abnormality in the DTI fiber tracer.(2)The order of the FA values in the control group was as follows: SCC,GCC,caudex cerebri CST,ICPL,ICGL,ICAL,The development of myelin sheath in the study A group and the control group had some regularity,The FA value of group B basically agreed with the rule of corpus callosum> caudex cerebri CST > capsula interna development.(3)The FA value of each part of the study group was lower than that of the control group,and there were significant statistically differences between group A and group C(P < 0.05),FA values of B and D were significantly different at ICPL,SCC and caudex cerebri CST(P <0.05).(4)There were significant differences in FA values after treatment comparing to the original datas(P <0.05),FA values after treatment were higher than those in each ROI,the largest increase was in right ICAL in both group.In addition to the GCC site,FA growth values of group A were greater than those of group B,FA growth value of ICPL was small.(5)After treatment,the study group GMFM-88 total score increased,group A growth value was smaller than that of group B,but the monthly relative growth rate of group A was greater than that of B group.(6)After treatment,there was a linear positive correlation between FA growth value and the growth of GMFM-88 in ICAL,ICGL,ICPL,SCC,caudex cerebri CST of the study group,among them,less than 1 year-old group had the most correlation in caudex cerebri CST,within the 1-3 year group ICPL was most relevant.Conclusions(1)There was the same law in the white matter fiber bundle myelination for the children with spastic cerebral palsy and normal children,the white matter fiber bundles of patients had different degrees of damage,and their developmental maturity were lower than those of normal children of the same age,their FA values were lower.DTI can objectively reflect the development of white matter fiber bundles in nurseling,and early detect the damage of white matter fiber bundle microstructure,and quantify the degree of injury,providing an objective basis for the assessment and prognosis of patients with spastic cerebral palsy.(2)Dynamic monitoring DTI found that after intervention and natural development,the FA value of white matter fiber bundles in children increased than before,and the development of white matter fiber bundles tended to be perfect,the younger age,the larger improvement rate,the better prognosis of nerve fibers.While the FA value of white matter fiber bundle increased,the function of gross motor improved,the monthly relative growth rate of GMFM-88 in the low age group was higher than that in the high age group.(3)The white matter fiber bundles of ICAL,ICGL,ICPL,SCC,caudex cerebri CST were all involved in motor function.their damage and motor dysfunction were closely related,the increase of FA value and the improvement of motor function were positive related,less than 1 year old group had the greatest correlation in caudex cerebri CST.1-3 years old group had the greatest correlation in ICPL.(4)Dynamic magnetic resonance diffusion tensor imaging plays an important role in evaluating the development and changs of nerve fiber bundles,and the therapeutic effect of motor function,It provides a reliable basis for disease assessment and prognosis in children with spastic cerebral palsy.