ABSTRACT
Objective To explore the value of diffusion tensor imaging (DTI)for the cerebral white matter recovery in children with cerebral palsy after cervical perivascular sympathectomy.Methods 30 children with hemiplegic cerebral palsy were recruited for 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.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 in preoperative contralateral side,and the differences were statistically significant(P<0.001).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<0.001),with the improvement of gross motor.Preoperative and postoperative FA value of the white matter fiber bundles in the different parts of the contralateral brain was not statistically significant(P>0.05).Clinical GMFCS in the patients were negatively correlated with the FA values (P<0.001).Moreover,the relativity between the GMFCS and the FA value of internal capsule and cerebral peduncle were both higher(r=-0.800,P<0.001;r=-0.786,P<0.001). Conclusion DTI can be used to quantitatively evaluate the postoperative recovery of white matter in children with cerebral palsy.The FA value can be used as a sensitive index for the evaluation of curative effect in children with cerebral palsy.
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Objective To investigate the change rules of the lumbar vertebral bone marrow fat fraction(FF)and T2* values at different bone mineral density(BMD)groups,and their relevances and the applications on the diagnosis of the primary osteoporosis. Methods The patients who underwent the dual energy X-ray absorptiometry(DXA)and the routine lumbar MRI scan,mDIXON-Quant scan were collected,and the BMD,T-score,FF and T2* values of L1-L4 were measured.According to the T-score,the vertebral bodies were divided into the normal group,the osteopenia group and the osteoporosis group.The differences of the FF,T2* values and BMD between each group were analyzed by one-way analysis of variance,and their correlations with BMD were analyzed by Pearson correlation,the diagnostic effects of them were evaluated by receiver operating characteristic curve(ROC curve).Results The differences of the FF ,T2 * values and BMD among the three groups were statistically significant (P < 0 .05) .The correlations of the FF and T2 * values with BMD were negative (r = - 0 .628 ,P < 0 .05 and r = - 0 .468 ,P < 0 .05 ,respectively) .The area under curve (AUC) of the FF and T2 * values were 0 .82 ± 0 .03 ,0 .79 ± 0 .03 ,respectively .Conclusion mDIXON-Quant which can accuratly quantify fat content could evaluate the lumbar vertebral bone marrow fat content ,reflect the changes of the bone quality ,provide valuable information for the diagnosis of osteoporosis ,and is helpful to predict the risks of the lumbar fragility fracture.
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Objective To discuss the value of DTI on recovery of white matter injury in periventricular leucomalacia (PVL) with cerebral palsy after surgery.Methods 15 childrens suffered from PVL and 15 age-matched normal controls with normal MRI findings and no neurological abnormalities were recruited in this study.Conventional plain MRI scans and DTI sequence of brain were preformed in all subjects.FA maps of eight selected regions,which included the corpus callosum genu,splenium of corpus callosum,bilateral anterior limb of internal capsule,bilateral posterior limb of internal capsule,bilateral optic radiation,bilateral cerebral pedunculusand superior longitudinal fasciculus were compared between two groups.Results Significant differences of FA values were observed among the three group before and after the treatment and control groups(P＜0.05).FA value of the caudate nucleus and lenticular nucleus among three group was not statistically significant difference.Further pairwise comparison,FA values of the posterior limb of internal capsul,genu of corpus callosum and splenium of corpus callosum in three groups showed statistically significant differences,there was no statistically significant difference for FA value of the genu of capsulae internae,cerebral peduncle and pons among the three group.Compared to the contralateral normal areas,FA value of the genu of capsulae internae,cerebral peduncle and pons showed statistically significant differences (P＜0.05).Conclusion Quantitative DTI may show subtle changes in the structure of white matter,which has a certain reference value of FA values of white matter in periventricular leucomalacia with cerebral palsy after surgery,and help clinicians further reasonable treatment.
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Objective To investigate the clinical diagnostic values of quantitative DTI and MRS in AIDS-related cerebral tuberculosis. Methods 17 cases confirmed with AIDS and brain tuberculosis,16 volunteers were recruited to perform routine MRI,DTI and MRS sequences. Morphological characteristics of lesions were observed.ADC,FA,rADC,rFA,NAA/Cho,NAA/Cr and Cho/Cr of the lesions solid areas,edematous areas,normal areas and contralateral corresponding normal areas were measured and their variances in different areas were analyzed. Results Significant differences of the values were observed among the three regions of AIDS-related brain tuberculosis,the results of multiple comparisons between the three areas had statistical significances (P <0.05)excepted NAA/Cr between edematous and contralateral areas.ADC,FA,rADC,rFA,NAA/Cho,NAA/Cr on solid areas were lower than that on edematous areas,Cho/Cr on solid areas was higher than that on other two areas.The diagnostic efficiency of rFA value to distinguish solid and edematous areas was the highest by ROC analysis(P <0.05).The normal areas of the two groups had statistical significances(P <0.05)excepted Cho/Cr.Conclusion DTI is valuable to display the lesions micro-structure changes and MRS can reflect the early pathology metabolites changes of AIDS-related tuberculosis.