小儿腰骶部隐性脊柱裂MRI表现及下肢功能障碍的关系研究

Relationship between the lumbosacral MRI performance of spina bifida occulta in children and lower limb dysfunction

摘要:

目的：研究小儿隐性脊柱裂（spina bifida occulta，SBO）的腰骶部核磁共振成像（magnetic resonance imaging，MRI）及下肢功能障碍表现，进行脊柱裂神经功能量表（Spina Bifida Neurological Scale，SBNS）评分，探讨小儿SBO腰骶部MRI表现及下肢功能障碍的关系。方法：对106例小儿腰骶部隐性脊柱裂及下肢功能障碍患儿行腰骶部MRI，对每位患者按SBNS量表进行神经功能评分，分析小儿SBO腰骶部MRI表现及下肢功能障碍的关系。结果：腰骶部MRI表现简单性畸形时，下肢功能障碍以轻度运动功能障碍及足畸形为主，腰骶部MRI表现复杂性畸形时，下肢功能障碍以重度运动障碍及足畸形为主；腰骶部MRI表现简单性与复杂性畸形的SBNS评分均数比较有显著性差异（t=4.548，P=0.023）。结论：MRI在小儿SBO及脊髓畸形诊断中有重要的意义；小儿腰骶部SBO患者SBNS 评分越低，下肢功能障碍越严重，MRI表现越复杂合并脊髓畸形越多；SBNS量表评分在SBO及下肢功能障碍中是比较有意义的评价方法。

Abstract:

Objective：To analyze the lumbosacral magnetic resonance imaging（MRI） performance of spina bifida occulta（SBO） and lower extremity dysfunction in patients combined with spina bifida neurological scale score（SBNS），and to investigate the relationship between lumbosacral MRI performance of SBO and lower extremity dysfunction. Methods：The lumbosacral MRI was performed on 106 children with spina bifida occulta and lower extremity dysfunction. SBNS scale was used to evaluate the relationship between lum－bosacral MRI performance of SBO and lower extremity dysfunction. Results：The lower limb dysfunction manifested as mild motor dys－function and foot deformity according to simple lumbosacral MRI manifestation. The lower limb dysfunction manifested as severe mo－tor dysfunction and foot deformity according to complex lumbosacral MRI manifestation. There were statistical differences in SBNS score between simple MRI manifestation and complex MRI manifestation（t=4.548，P=0.023）. Conclusion：MRI is valuable in the di－agnosis of the SBO and associated malformations.The more serious the lower extremity dysfunction，the lower the SBNS score；the more complex the MRI manifestation，the more serious the spinal cord deformity. SBNS scale in meaningful in the evaluation of SBO and lower limb dysfunction.