Diffusion Tensor Imaging To Evaluate The Value Of Treatment With Cervical Perivascular Sympathectomy In Children With Cerebral Palsy

Objective: To explore the value of magnetic resonance diffusion tensor imaging(DTI)and diffusion tensor tracking(DTT)on evaluating the cerebral white matter recovery in children with cerebral palsy after cervical perivascular sympathectomy.Methods: Thirty children with hemiplegic cerebral palsy accepted clinical assessment and routine MRI and DTI examination before and after operation.The fractional anisotropy(FA)values for the regions including internal capsule and cerebral peduncle in the preoperative operation side and the opposite side,preoperative and postoperative,were measured and compared.3D reconstruction of white matter tracts was employed.The gross motor function classification system(GMFCS)was used to evaluate the movement function of cerebral palsy in children.Paired sample t test was performed to compare the differences of FA values between the preoperative operation side and the lateral,preoperative and postoperative white matter.Spearman relativity analysis was performed to assess correlation between DTI parameters in different white matter fiber bundles and GMFCS in patients.Results: The FA values of white matter fiber bundle in different parts of the preoperative operation side were significantly lower of the preoperative contra lateral,the differences were statistically significant(P<0.05).Compared to preoperative,the FA values of white matter fiber bundle in different parts of the operation side were significantly increased in the six months after surgery(P<0.05),the gross motor function had been improved.There was no statistically significant difference between the six months after surgery and the preoperative period of the FA value of white matter fiber bundles in different parts of the contra lateral(P>0.05).The clinical GMFCS in the patients were negatively correlated with the FA values(P<0.05).Moreover,the relativity between the GMFCS and the FA value of internal capsule and cerebral peduncle were both higher(r=-0.800,P<0.05;r=-0.786,P<0.05).Conclusions: DTI combined with DTT can be used to quantitatively evaluate the postoperative recovery of white matter in children with cerebral palsy;it plays an important role in adjuvant clinical treatment and prognosis assessment.