婴幼儿多囊性脑软化磁共振诊断  

MRI Diagnosis of Multicystic Encephalomalacia in Infants

作　　者：张霞 安丰新 李璐燕 郭俊红 孙盼 ZHANG Xia;AN Fengxin;LI Luyan;GUO Junhong;SUN Pan(Department of Radiology,Chengyang People's Hospital of Qingdao City,Shandong Province;Huangdao Ping An Medical Imaging Diagnosis Center,Qingdao,Shandong Province;Zhengzhou Meinian Health Technology Co.,Ltd)

机构地区：[1]山东省青岛市城阳区人民医院影像科 [2]山东省青岛市黄岛平安医学影像诊断中心 [3]郑州美年大健康科技有限公司门诊部

出　　处：《中国医学计算机成像杂志》2024年第1期96-100,共5页Chinese Computed Medical Imaging

摘　　要：目的:分析多囊性脑软化的MRI表现,以提高对此病的认识。方法:22例多囊性脑软化患儿(年龄7 d至17个月)纳入回顾性分析,全部完成颅脑MRI检查(SIEMENS ESSENZA 1.5 T MR机),6例超过2次检查,分析其MRI特征和规律。结果:全脑型15例,半脑型3例,局部型4例。MRI见皮质及皮质下区脑软化,脑回结构可见,其中5例合并基底节区或背侧丘脑软化灶。所有病例脑白质容量减少,脑室扩张,胼胝体变薄。6例随访病例,初次检查急性脑水肿期4例、脑细胞坏死期2例,复查都处于脑软化形成期,即形成多囊性脑软化。4例脑缺氧缺血性脑病(HIE)患儿在出生后1周左右见弥散加权成像(DWI)高信号。DWI信号增高(4例)、短T1信号(3例)域,复查形成更明显脑软化。结论:多囊性脑软化的MRI表现有一定特征,皮质和皮质下区结构损伤,可提示诊断。HIE患者早期DWI高信号和短T1信号提示可能发展成更明显的脑软化。Purpose:To improve the diagnosis of multicystic encephalomalacia(MCE)by analyzing the MRI manifestations.Methods:A total of 22 MCE infants(aged from 7 days to 17 months)were analyzed retrospectively.All of them completed brain MRI examination by SIEMENS ESSENZA 1.5 T MR Machine,and 6 cases were examined more than once.The MRI characteristics and regularity were analyzed.Results:There were 15 cases of whole brain type,3 cases of half brain type and 4 cases of local type.All the MRI showed cortical and subcortical encephalomalacia,but the gyri structure was still visible,and 5 cases of them had encephalomalacia in basal ganglia or dorsal thalamus.All of the damaged brains had reduced white matter volume,dilated ventricle,and thinner corpus callosum.In the first examination of the 6 follow-up cases,there were 4 cases in the acute cerebral edema stage and 2 cases in the cerebral necrosis stage,and all the 6 cases resulted in MCE.High DWI signal was observed in 4 infants with hypoxic ischemic encephalopathy(HIE)around 1 week after birth.The areas with increased DWI signal(4 cases),and short T1 signal(3 cases)formed more obvious encephalomalacia in the following examination.Conclusion:The MRI of MCE have certain manifestations.The diagnosis can be made when there are damages of the cortex and subcortical areas in infants.Areas with high DWI signal and short T1 signal in the early stage of HIE patients may develop obvious encephalomalacia.

关 键 词：多囊性脑软化 核磁共振 缺氧缺血性脑病 婴幼儿 

分 类 号：R445.2[医药卫生—影像医学与核医学]