10例儿童脑寄生虫病临床特征及MRI表现  

Clinical features and MRI findings of 10 cases of parasitic encephalopathy

作　　者：陈希文 张笑春 陈连凤 鹿连伟 吴慧莹 周宁 CHEN Xiwen;ZHANG Xiaochun;CHEN Lianfeng;LU Lianwei;WU Huiying;ZHOU Ning(Department of Radiology,Guangzhou Women and Children's Medical Center,Guangzhou 510623,China;Department of Neurology,Guangzhou Women and Children's Medical Center,Guangzhou 510623,China)

机构地区：[1]广州市妇女儿童医疗中心放射科,广东广州510623 [2]广州市妇女儿童医疗中心神经内科,广东广州510623

出　　处：《中国医学影像技术》2022年第11期1616-1620,共5页Chinese Journal of Medical Imaging Technology

基　　金：广东省医学科学技术研究基金(A2021261)。

摘　　要：目的 观察儿童脑寄生虫病临床特征与MRI表现。方法 回顾性分析10例经实验室检查确诊脑寄生虫病患儿,包括广州管圆线虫感染8例、弓形虫及裂头蚴感染各1例。结果 10例中,3例有流行病学史;发热9例,精神倦怠及呕吐各6例,运动障碍5例,头痛3例,抽搐及意识障碍各1例。10例外周血嗜酸性粒细胞(EOS)均升高;9例脑脊液白细胞升高,6例EOS比例升高,8例微量蛋白升高,8例葡萄糖降低。增强MRI中,8例脑广州管圆线虫病患儿均见软脑膜结节状和/或线样强化,其中1例伴左侧额叶单发圆形强化灶;1例脑弓形虫病延髓病灶呈结节状强化,软脑膜呈线样强化;1例脑裂头蚴病右侧额叶、顶叶等多发病灶呈结绳样、串珠样强化,邻近软脑膜呈线样强化。结论 脑寄生虫病患儿流行病学、外周血与脑脊液实验室检查结果具有一定特征;其MRI表现多样,与寄生虫种类相关。Objective To observe the clinical features and MRI findings of children with parasitic encephalopathy. Methods Data of 10 children with parasitic encephalopathy confirmed by laboratory were reviewed, including 8 cases of angiostrongyliasis cantonensis, 1 case of toxoplasmosis and 1 case of sparganum. Results Among 10 cases of parasitic encephalopathy, 3 had epidemiological history, 9 were found with fever, 6 with mental burnout and vomiting, 5 with movement disorder, 3 with headache and 1 with convulsion and disturbance of consciousness. Peripheral blood eosinophils(EOS) increased in all 10 cases. Cerebrospinal fluid white blood cell increased in 9 cases, EOS proportion increased in 6 cases, microprotein increased in 8 cases, and glucose decreased in 8 cases. Eight cases of cerebral angiostrongyliasis cantonensis showed nodular and/or linear enhancement on enhanced MRI, including 1 case with a single round enhancement in the left frontal lobe. One case of cerebral toxoplasmosis showed nodular enhancement of medulla oblongata lesions and pia meningeal line enhancement, while 1 case of cerebral sparganum presented with cord-like and beaded enhancement in the right frontal and parietal lobes adjacent to pia line enhancement. Conclusion The epidemiology, results of peripheral blood and cerebrospinal fluid laboratory examination had certain characteristics in children with parasitic encephalopathy. MRI findings of parasitic encephalopathy were various, related to the species of parasites.

关 键 词：脑 寄生虫病 儿童 磁共振成像 

分 类 号：R725.3[医药卫生—儿科] R445.2[医药卫生—临床医学]