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.