儿童轻微脑炎／脑病伴可逆性胼胝体压部病变MRI诊断价值  

MRI diagnostic value for the spectrum of mild encephalitis/encephalopathy with a reversible splenial lesion in children

作　　者：王芳[1] 孙丹[2] 邵剑波[1] 沈杰峰[1] 唐映波[1] 

机构地区：[1]武汉市儿童医院CT8LMR影像科,湖北武汉430016 [2]武汉市儿童医院神经内科,湖北武汉430016

出　　处：《实用放射学杂志》2016年第1期86-89,110,共5页Journal of Practical Radiology

基　　金：武汉市科技创新平台资助项目（武科技2014-160号）.

摘　　要：目的 探讨儿童轻微脑炎/脑病伴可逆性胼胝体压部病变（MERS）的临床表现及MRI影像特征。方法 对本院8例MERS患儿的临床特点、影像学变化以及脑电图等进行回顾性分析，检查设备采用GE Signa Excite 1.5T HD Echospeed及Discovery MR750 3.0T扫描仪。结果 8例患儿影像学改变均累及胼胝体压部，病灶特征呈类圆形， T1WI呈等或稍低信号，T2WI及FLAIR呈稍高信号，DWI上呈明显高信号，相应表观扩散系数（ADC）序列上呈低信号为典型特征，其中6例在DWI显示胼胝体压部孤立性受累而被诊断MERSⅠ型；另2例中1例扩展到整个胼胝体，1例扩展到半卵圆中心白质被诊断MERSⅡ型，随访7 d^1月患儿复查头颅MRI均恢复正常。结论 MERS临床上表现为急性轻微脑炎/脑病症状，为临床-影像学预后良好的一种综合征； MRI对其诊断、鉴别诊断及为临床治疗提供依据具有很大价值，为首选影像学检查方法。Objective To investigate clinicoradiological characteristics for the spectrum of mild encephalitis/encephalopathy with a reversible splenial lesion（MERS） in children. Methods The clinical course, magnetic resonance imaging （United States GE Signa Excite 1.5T HD Echospeed and Discovery MR750 3.0T scanner） and eleetroeneephalography （EEG） findings in 8 children with MERS were analyzed retrospectively. Results Brain MRI revealed that the lesion in the splenium of corpus callosum （SCC） shared common clinical features in all 8 patients. The SCC lesion included oval lesion, equal or slightly low signal on T1 WI, slightly hyperin tensity on T2 WI and FLAIR, hyperintensity on DWI sequence and hypointensityon the corresponding ADC images. Among 8 children, MERS type T was diagnosed in 6 children who exhibited lesions in the splenium of corpus callosum only, and MERS type 11 in 2 children with lesion extended from the splenium of corpus callosum to the whole corpus callosum and semiovale respectively. The lesion was completely disappeared in all patients at follow-up MRI exams between ？ days to 1 month after the initial MRI. Conclusion MERS exhibits a spectrum of clinico-radiological features. The clinical features among the affected patients are nearly identical, consist of relatively mild CNS manifestations and complete recovery in clinical and imaging. MRI has great values in differential diag nosis,provides a reference for clinical treatment of reversible lesion in the splenium of corpus callosum and will be the first choice of imaging examination method.

关 键 词：儿童 轻微脑炎/脑病伴可逆性胼胝体压部病变 磁共振成像 

分 类 号：R512.3[医药卫生—内科学] R445.2[医药卫生—临床医学]