儿童中枢神经系统表面含铁血黄素沉积症5例分析  

Pediatric superfical siderosis of central nervous system:analysis of 5 cases

作　　者：徐健[1] 高继勇[1] 高军[1] 廖海波[2] 王琦民 梅海炳 

机构地区：[1]浙江省宁波市妇女儿童医院影像科,浙江宁波315012 [2]宁波大学医学院附属医院影像科,浙江宁波315020

出　　处：《医学影像学杂志》2018年第2期313-317,共5页Journal of Medical Imaging

基　　金：浙江省医药卫生科技计划项目(编号:2015KYB341)

摘　　要：目的探讨儿童中枢神经系统表面含铁血黄素沉积症(SSCNS)临床表现和磁共振(MRI)影像特点,提高对该病的诊断水平。方法回顾性分析宁波市妇女儿童医院2014年2月~2016年10月间收治的5例经临床和MRI影像检查确诊的儿童SSCNS患者资料,5例患儿均行MRI常规扫描、梯度回波T2*加权(GRE-T2*WI)序列以及磁敏感加权成像(SWI)序列扫描,分析其临床表现和MRI信号特征。结果 5例患儿中:有2例患儿单侧听力进行性减退,1例Barbinski征阳性,3例患儿有头疼或头晕病史,1例患儿单侧视力减退,1例患儿有癫痫病史。MRI影像中:T2WI、GRET2*WI和SWI分别在左侧额下回皮质表面、右侧额叶皮质表面、右侧颞叶皮质表面、左顶叶局部皮质表面和右侧外侧裂池下方的颞叶皮质表面覆盖线条样低信号影;病变在T1WI序列上呈低信号,显示不明显。结论儿童SSCNS临床表现有别于成人;MRI是其首选检查方法,GRE-T2*WI序列显示SSCNS较为直观,SWI序列显示病变敏感性最高。Objective To study the clinical manifestations and magnetic resonance imaging （MRI） features of superficial sid- erosis ofcentral nervous system （SSCNS） in children so as to improve the level for the diagnostic s of this disorder. Methods A retrospective analysis of 5 pediatric SSCNS patients, who were confirmed by clinical and MR/ imaging examination in Ningbo woman ＆ children＇s hospital from February 2014 to October 2016, was conducted in this work. All those 5 patients underwent routine MRI scanning, T~ ＊ -weighted gradient echo sequence （ GRE-T2 ＊ WI）, and susceptibility weighted imaging （SWI） se- quence scanning. Then, the clinical manifestations and MRI signal characteristics were analyzed. Results In those five chil- dren, two children presented with unilateral hearing loss, one with Barbinski positive sign, 3 with headache or dizziness history, one with unilateral vision loss, and one with a history of epilepsy. The MRI images of T2WI, GRE-T2 ＊ WI and SWI exhibited the low signal shadow in the left frontal cortex of temporal lobe cortex, right inferior surface covering the surface of the frontal cortex surface, right temporal lobe and local cortical surface of left parietal lobe cortex surface and the right lateral fissure, respectively. The lesions showed slightly low signal in the sequence of T1WI, with no obvious manifestation. Conclusion The clinical mani- festations of SSCNS in children are different from those in adults. MRI is the preferred method for the examination of SSCNS in children. GRE-T2 ＊ WI sequence is more intuitive and has the highest sensitivity in showing SSCNS in children.

关 键 词：表面含铁血黄素沉积 中枢神经系统 儿童 磁共振成像 

分 类 号：R741[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]