小儿流行性乙型脑炎的临床及MRI特征分析  

Analysis of brain MRI and clinical features of Japanese encephalitis in children

作　　者：李晓明[1] 金科[1] 李殊明[1] 段友方[1] 汪圣[1] 

机构地区：[1]湖南省儿童医院放射科,长沙410007

出　　处：《中国医师杂志》2011年第4期467-470,共4页Journal of Chinese Physician

摘　　要：目的探讨小儿流行性乙型脑炎（乙脑）的临床特点与颅脑MRI影像特征及其与预后的关系，为临床早期诊治提供依据。方法回顾性分析本院收治的145例流行性乙型脑炎患儿的临床及MRI资料。98例行0．35TMRI检查获得常规T1WI、T2WI及FLAIR序列，47例行1．5TMRI检查除采集常规序列外，还采集了DWI序列。分析脑部MRI表现：病灶累及的部位、范围和MRI信号特征。结果MRI平扫中106例（73．1％）发现脑实质异常信号影，其病灶不同程度的累及丘脑，87例同时累及中脑大脑脚，同时累及基底节、脑皮质及小脑受累分别为32例、43例和2例；15例累及脑白质。病灶表现为不同范围的T2WI高信号病变，T1WI多呈低信号，少数呈等信号。FLAIR上全部可见高信号灶，少数高信号灶中心可见低信号影。38例FLAIR显示脑实质异常信号灶较T2WI更多。DWI上28例可见脑实质高信号病灶，12例可见低信号病灶，7例在DWI及ADC图均呈等信号改变。1．5TMRI阳性率（87．2％）明显高于0．35TMRI（66．3％，X^2=7．06，P〈0．01）。结论MRI能显示乙脑患儿颅脑病变的部位及范围，累及丘脑及中脑大脑脚为其特征性表现。FLAIR及DWI对乙脑的早期诊断具有很高的价值。Objective The purpose of this study was to investigate the clinical features and the magnetic resonance imaging of brain of children with Japanese encephalitis （JE） and whether this relationship can be used in early diagnosis. Methods MRI was performed in 145 children with JE. Tl-weighted, T2-weighted and FLAIR of brain were obtained in 98 patients with 0. 35 T MRI system and conventional MRI and DWI were performed in 47 patients with 1.5 T MRI system. The position, range and MRI features were analyzed. Results MR imaging studies of 106 patients showed hyperintensity in the thalamic with 87 patients involved the caudex cerebri, as seen on T2-weighted images. The lesions were also seen in basal ganglia （32 cases）, cerebral cortex （43 cases）, cerebellum （2 cases）, and white matter （15 cases）. Le- sions showed high intensity signal on T2WI and T2-FLAIR, and iso- or low intensity on T1WI. The number of the lesions in FLAIR were more than T2WI. The positive rate on 1.5 T MRI （87.2%） was higher than that on 0. 35 T MRI（66. 3%, X^2=7.06, P 〈 0. O1 ）. Conclusions Muhiple brain tissues can be involved and the thalamic and the caudex cerebri involvement are the conspicuous characteristics in children with JE. T2-FLAIR and DWI are helpful in the early diagnosis of JE.

关 键 词：脑炎/诊断/放射摄影术 磁共振成像 

分 类 号：R72[医药卫生—儿科] R44[医药卫生—临床医学]