MRI study on morphological changes in hand knob regions in children with spastic hemiplegia
Wu Fan1,2, Li Xianjun1, Liu Heng1, Huang Tingting1, Jiang Haoxiang1, Yang Jian1
1Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China; 2Department of Radiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou 510623, China
Abstract：Objective This study explores morphological changes in hand knob regions (HKRs) in children with spastic hemiplegia. Methods Children (case group) who were diagnosed with spastic hemiplegia and underwent brain MRI were retrospectively enrolled (3.9±2.1 years old; eight males, six females). The imaging findings were predominant white matter injury (periventricular leukomalacia; n=10), predominant gray matter injury (n=3), and white matter injury combined gray matter injury (n=1). Twenty-eight normal children (4.1±2.0 years old) as the control group were paired with the spastic hemiplegia group in a ratio of 2:1. They were matched with a spastic hemiplegia group in terms of age, gender, and bilateral HKR type. The HKR morphology characteristics (the width, height, and cortical thickness of HKR) were evaluated and measured on the best evaluation plane (T1WI axial imaging showed that bilateral superior frontal sulcus was located in the anterior middle of bilateral hemispheres, and the central sulcus was as deep as 1/3 of the ipsolateral hemisphere, and the shape of HKR could be well observed) according to 3D T1WI in different age groups. First, the height of the white matter of HKR (the height of HKR minus the cortical thickness of HKR), ratio between the height and cortical thickness and the ratio between the height of the white matter and cortical thickness of HKR were calculated. Then, the mean value of each morphological characteristic of two normal children paired with a patient was calculated. Paired t test, independent sample t test or u test of two related samples were used to compare between the affected hemisphere side and unaffected hemisphere side of children with hemiplegia, and children with hemiplegia and those in the control group in terms of seven morphological characteristics. Intra- and interobserver reliability was evaluated using the interclass correlation coefficient (ICC) test. Results No significant differences in age, gender, and bilateral HKR type were found between the two groups (all P values >0.05). The analysis of the morphological characteristics of HKR showed significant difference in the ratio of HKR height and cortex thickness (3.41±1.03 vs. 3.96±1.17) and the ratio of HKR white matter height and cortex thickness (2.41±1.03 vs. 2.96±1.17) between affected and unaffected hemispheres in children with spastic hemiplegia (t=2.49, 2.49; all P values <0.05). There was no significant difference in other MRI characteristics within the case group (all P values >0.05). In addition, significant differences in HKR height ([7.13±1.40] mm vs. [8.65±1.01] mm), HKR white matter height ([4.89±1.47] mm vs. [6.77±0.99] mm), ratio between HKR height and HKR cortex thickness (3.41±1.03 vs. 4.70±0.79), and ratio between HKR white matter height and HKR cortex thickness (2.41±1.03 vs. 3.70±0.79) in the affected hemisphere were found between children with spastic hemiplegia and the control group (t=2.91, 3.58, 3.71, 3.71; all P values <0.05). Meanwhile, the mean values of these characteristics were lower than those in the control group. There was no significant difference in other MRI characteristics between the two groups (all P values >0.05). Conclusion In children with spastic hemiplegia, the height of HKR white matter in affected hemispheres decreased, but the cortex thickness and the width of HKR showed no significant changes.
吴璠, 李贤军, 刘衡, 黄婷婷, 蒋昊翔, 杨健. 痉挛型偏瘫儿童手节区形态学变化的MRI研究[J]. 中华解剖与临床杂志, 2022, 27(8): 545-550.
Wu Fan, Li Xianjun, Liu Heng, Huang Tingting, Jiang Haoxiang, Yang Jian. MRI study on morphological changes in hand knob regions in children with spastic hemiplegia. Chinese Journal of Anatomy and Clinics, 2022, 27(8): 545-550.
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2022, Vol. 27 
