磁共振及弥散加权成像对小儿病毒性脑炎的早期诊断价值  

The early diagnostic value of magnetic resonance imaging and diffusion weighted imaging for child case with viral encephalitis

作　　者：翁淑萍[1] 施跃全[1] 方如旗[1] 庞万良[1] 刘朝禄[1] 

机构地区：[1]福建省妇幼保健院,福州350001

出　　处：《海峡预防医学杂志》2015年第3期11-14,共4页Strait Journal of Preventive Medicine

基　　金：福建省妇幼保健院课题(No.FBYY09-21)

摘　　要：目的探讨小儿病毒性脑炎磁共振成像(MRI)及磁共振弥散加权成像(DWI)的早期表现和临床应用价值。方法收集29例病毒性脑炎患儿的MRI及DWI资料,回顾性分析MRI早期表现,比较病灶与对侧正常脑组织的ADC值差异。结果小儿病毒性脑炎均为多发病灶,多位于大脑半球皮层及皮层下区,多累及颞叶、额叶和顶叶等,呈斑点状或斑片状异常信号。常规MRI序列和DWI显示病灶18例,Flair和DWI显示病灶8例,仅DWI显示病灶3例;T1WI呈稍低信号,T2WI及FLAIR呈稍高信号,DWI呈稍高或高信号。29例的DWI均发现病灶;ADC呈稍低信号,患侧ADC均值较对侧正常脑组织低。结论小儿病毒性脑炎的MRI早期表现有一定特征,DWI能早期发现病灶,对小儿病毒脑炎的早期诊断有重要价值。Objective To explore the early features and clinical application of magnetic resonance imaging（MRI）and diffusion weighted imaging（DWI）for child case with viral encephalitis.Methods MRI,DWI data of 29 cases were collected and early MRI features were analyzed,apparent diffusion coefficient（ADC）values of lesions were compared with the contralateral normal brain tissue.Results The lesions of the cases were multiple usually,mostly located in the cortex and subcortex of the cerebral hemisphere,mainly involving the temporal lobe,frontal lobe,parietal lobe and so on.Punctate or pathy abnormal signal were noted.Totally 18 cases of the lesions were showed by conventional MRI and DWI sequences,eight cases showed by Flair and DWI sequences,three cases can only be showed by DWI sequence.The lesions demostrated slightly hypointensity in T1 WI sequence,slightly hyperintensity in T2 WI and FLAIR sequences,and slightly hyperintensity or high intensity in DWI sequence.DWI sequence acted as important method to find lesions easily with 100% display rate（29cases）.ADC value was slightly lower compared with the contralateral normal brain tissue.Conclusion The early MRI features in cases with viral encephalitis shows specific characteristics,DWI sequence plays a significant role for early detecting lesions and early diagnosis of viral encephalitis.

关 键 词：病毒性脑炎 小儿 磁共振成像(MRI) 弥散加权成像(DWI) 表观扩散系数(ADC) 

分 类 号：R512.3[医药卫生—内科学]