儿童肺吸虫脑病25例临床与影像学特征  

Clinical and imaging characteristics of cerebral paragonimiasis in children

作　　者：张高峰[1] 刘衡[1] 席珊珊[1] 

机构地区：[1]遵义医学院附属医院影像科,贵州遵义563003

出　　处：《中国实用儿科杂志》2015年第7期540-543,共4页Chinese Journal of Practical Pediatrics

摘　　要：目的探讨儿童肺吸虫脑病临床表现和磁共振成像（MRI）特点。方法收集2012年6月至2014年10月遵义医学院附属医院临床确诊的肺吸虫脑病患儿25例,年龄6~14岁,回顾性分析其临床资料和MRI影像学表现。结果 25例中18例有明确生食溪蟹、淡水虾史。临床表现：头痛23例,癫痫11例,发热9例;25例外周血嗜酸性粒细胞绝对数及百分比均升高,肺吸虫血清抗体均阳性。MRI特征：24例病灶位于大脑皮质和皮质下区,1例位于丘脑,累及顶叶14例、颞叶10例、枕叶8例、额叶6例。脑实质出血16例,多表现为皮质及皮质下单一血肿团;脑炎型9例,表现为大片水肿和环形、结节样强化,其中＂隧道征＂3例。合并胸部肺吸虫病10例。结论儿童肺吸虫脑病临床表现复杂,MRI表现具有特征性,诊断应结合影像学、血嗜酸性粒细胞计数及免疫学检查做到早诊断、早治疗。Objective To explore clinical manifestation and MR[ features of cerebral paragonimiasis. Methods The clinical and MR[ findings of 25 patients with cerebral paragonimiasis were analyzed retrospectively. Results Eighteen cases had eaten raw or undercooked freshwater crabs or crayfish. Twenty-three cases had headache, and there were 11 cases epilepsy and 9 cases fever. Peripheral blood eosinophilia in all cases increased, and the paragonimus serum antibody were positive in all cases.Magnetic resonance imaging features ：in 24 cases was located in cerebral cortex and subcortical areas, 1 case in the thalamus, 14 cases in parietal lobe, 10 cases in temporal lobe, 8 cases in occipital lobe, and 6 cases in frontal lobe.Sixteen cases manifested as cerebral hemorrhage, and most cases were located in cerebral cortex and subcortical areas.Nine cases of encephalitis type showed a large edema, and ring or nodular enhancement.The＂tunne]＂ sign was found in 3 cases.Para- gonimiasis was found in 10 cases. Conclusion The clinical manifestations of children cerebral paragonimiasis are complex. The MRI findings of children cerebral paragonimiasis have certain characteristics.For early diagnosis and treatment, the combination of imaging findings, eosinophil count, and immunological test should be required.

关 键 词：肺吸虫 磁共振成像 儿童 脑出血 

分 类 号：R72[医药卫生—儿科]