脑性瘫痪与头颅MRI分类系统的临床研究进展

The Clinical Research Progress of Cerebral Palsy and MRI Classification System

摘要: 目前脑性瘫痪(cerebral palsy, CP)的诊断主要基于临床症状和体征，而头颅影像学检查异常是CP诊断强有力的辅助条件。欧洲脑性瘫痪监测组织(surveillance of cerebral palsy in Europe, SCPE)根据大脑发育期间受到损伤时间的不同导致大脑损伤部位不同，开发了一套新的头颅磁共振分类系统(MRI classification system, MRICS)。紧接着，不同国家和地区对CP和MRICS之间的联系展开了研究。MRICS可以在一定程度上揭示CP的临床特征，预测CP的预后。白质损伤为主型是最主要的类型，与早产、低出生体重密切相关，而其他类型多与足月儿、正常出生体重有关。白质损伤为主型和MRI正常型的损伤程度较其他类型更轻。癫痫在灰质损伤为主型和混合型的发病率更高。然而，MRICS对CP临床预测的意义仍有一定的局限性，目前还缺乏对MRICS亚组与CP之间关系的分析。

Abstract: The diagnosis of cerebral palsy (CP) is mainly based on clinical symptoms and signs, and abnormal neuroimaging is a powerful auxiliary condition for diagnosis. The surveillance of cerebral palsy in Europe (SCPE) developed a new skull MRI classification system (MRICS) based on pathogenic patterns related to the period of brain development. Subsequently, different countries and regions have conducted researches on the relationship between CP and MRICS. To some extent, MRICS can reveal the clinical features of CP and predict the prognosis of CP. The dominant type of MRICS was the predominant white matter injury, which was closely related to premature birth and low birth weight, while the other groups were mostly related to full-term infants and normal birth weight. In terms of the degree of motor dysfunction, the predominant white matter injury and normal groups were much milder than the other groups. In addition, the incidence of epilepsy was higher in the predominant white matter injury and miscellaneous groups. However, the significance of MRICS for clinical prediction of CP still has some limitations, and there is a lack of analysis of the relationship between MRICS subgroups and CP.