中文摘要：

目的探讨儿童脑室周围白质软化（PVL）MRI表现与临床症状的相关性。方法选取本科47例PVL患儿,回顾性调查其围生期感染、出生体质量、胎龄及窒息情况;分析其MRI表现,包括脑室周围异常高信号、脑室扩大、皮质损伤、脑白质减少程度和胼胝体发育不良,进行PVL、脑性瘫痪（脑瘫）程度及语言障碍分级及视听觉筛查、智力检测,语言发育明显落后的患儿进行孤独症筛查：≥2岁应用孤独症行为量表（ABC）,〈2岁应用孤独症儿童评定量表（CARS）,有抽搐发作的患儿进行脑电图（EEG）检查。分析PVL分级与胎龄、出生体质量、围生期感染、窒息、脑瘫及语言障碍程度、视听觉障碍、智力及癫的相关性。结果 47例患儿中3例运动发育正常,其中完全性耳聋2例,孤独症1例,余44例均诊断为脑瘫,其中听力障碍24例,视觉障碍19例,其中1例皮质盲,发育商正常仅1例,并癫发作11例,其中West综合征2例。按照白质异常信号的范围、脑室扩大及白质减少程度、胼胝体发育情况及有无皮质损害将PVL分为3级,其中Ⅰ级14例,Ⅱ级21例,Ⅲ级12例。围生期感染可导致PVL分级上升（P=0.011）;胎龄、出生体质量、窒息与PVL分级无明显相关性（P〉0.05）;随着PVL级别的上升,脑瘫、智力低下程度加重（P=0.019、0.000）,视觉障碍增多（P=0.024）;脑白质减少程度与语言障碍、智力低下、听觉障碍程度及视觉障碍均有相关性（P=0.000、0.000、0.001、0.000）;脑室扩大程度与语言发育障碍、智力低下程度及视觉障碍有明显相关性（P=0.000、0.000、0.000）;伴随皮质损害时,听觉障碍程度加重（P=0.000）;胼胝体发育不良时,脑瘫、语言障碍、智力低下程度加重（P=0.008、0.001、0.000）;癫的发生与PVL分级及MRI表现无明显相关。结论减少围生期感染可减轻PVL程度;PVL影响患儿的运动、语言、视听觉及智力发育,其MRI表?

英文摘要：

Objective To explore the relationship between magnetic resonance imaging（MRI） findings of periventricular leukomalacia（PVL） and clinical symptoms in children.Methods The clinical features of 47 cases of PVL were retrospectively surveyed,including birth weight,the perinatal infection,gestational age and asphyxia.The MRI findings were also analyzed,including the abnormal singal around ventricle,the degree of quantitative reduction of white matter,ventricular enlarged,the cortex damage and the corpus callosum dysplasia.The ability of movement,language,audition-vision and intelligence were examined.The children with language disorder were observed for autism beha-vior checklist（ABC） or the child autism rating scale（CARS）.The electroencephalography（EEG） were detected when seizure.The correlation between PVL grade and gestational age,birth weight,the perinatal infection,asphyxia,cerebral palsy,the degree of language disorder,audition-vision disorder,intelligence and epilepsia was analyzed respectively.Results Of all 47 cases,3 cases were normal in motor development,including 1 case of autism,2 cases of deafness.Forty-four cases were paralysis,including dysaudia in 24 cases,visual disorder in 19 cases,including 1 case of cortical blindness.Only 1 child was of normal intelligence,epilepsy in 11 cases,including 2 cases of West syndrome.The severity of MRI abnormalities was graded into 3 degree by the following items：ventricular size,extension of white matter signal intensity,white matter loss,thinning of the corpus callosum.The children with degree Ⅰ of PVL were 14 cases,with degree Ⅱ were 21 cases,with degree Ⅲ were 12 case.The severity in the degree of PVL was correlated with perinatal infection（P=0.011）,but not with gestational age,birth weight or asphyxia（P0.05）.The level of PVL was associated with the mental retardation,cerebral palsy and visual disorder（P=0.019,0.000,0.024）.The degree of quantitative reduction of white matter was correlated with language disorder,visual-audito