MRI早期评估新生儿化脓性脑膜炎的临床应用价值  

Clinical value of MRI in early evaluation of the neonatal purulent meningitis

作　　者：张丹[1] 富建华[1] 薛辛东[1] 郭静[1] 胡奕[1] 

机构地区：[1]中国医科大学附属盛京医院新生儿科、放射科,沈阳110004

出　　处：《中国小儿急救医学》2011年第3期217-219,229,I0001,共5页Chinese Pediatric Emergency Medicine

摘　　要：目的回顾性分析新生儿化脓性脑膜炎MRI[常规MRI和弥散加权成像（diffusion weighted imaging，DWI）]影像学特征，为早期评估新生儿化脓性脑膜炎提供依据。方法选取2004年7月至2009年7月中国医科大学附属盛京医院新生儿内科收治的20例确诊为化脓性脑膜炎的足月新生儿，其中男14例，女6例。全部患儿在确诊后72h内完成常规MRI及DWI检查。结果（1）20例患儿中有19例（95％）出现异常；其中脑梗死7例（35％，7／20），硬膜下积液4例，脑软化3例，脑积水1例，脑室管膜炎1例；全部患儿中有7例存在颅内出血；（2）7例脑梗死患儿中，5例显示出DWI高信号以及Tl低信号、T2高信号；另2例仅显示DWI高信号，而T1、他均正常。结论新生儿化脓性脑膜炎初期即可有梗死及出血等脑损害，不论中枢神经系统症状及体征是否明显，均应行常规MRI检查，DWI检查在化脓性脑膜炎早期患儿中更为重要。Objective To analyze MRI manifestation of the neonatal purulent meningitis retrospec tively,including conventional MRI and diffusion-weighted imaging （ DWI）, and to evaluate the value of MRI in early assessment of the neonatal purulent meningitis. Methods From Jul 2004 to Jul 2009,20 full-term newborns （ 14 male,6 female） from Shengjing hospital were included in this study,all of which were diagnosed as purulent meningitis. MRI and DWI examinations were performed within 72 h after the diagnosis. Results （ 1 ） Among those 20 infants, 19 infants （95%） had positive findings, including 7 cases of cerebral infarction ,4 cases of subdural effusion,3 cases of encephalomalacia, 1 case of hydrocephalus, 1 case of ependymitis and 7 cases of intracranial hemorrhage. （2） Among the 7 cases of infarction, 5 cases showed hypointensity on T1WI and hyperintensity on DWI and T2WI, but the other 2 cases only showed hyperintensity on DWI. Conclusion MRI can detect infarction and hemorrhage in the early stage of purulent meningitis. So MRI, es- pecially DWI,is very important for the early diagnosis and evaluation of neonatal purulent meningitis.

关 键 词：化脓性脑膜炎 磁共振成像 弥散加权成像 新生儿 

分 类 号：R722.1[医药卫生—儿科] R445.2[医药卫生—临床医学]