摘要
目的:探讨儿童尿毒症脑病的MRI诊断及鉴别诊断价值。方法:28例儿童尿毒症脑病患儿行颅脑MRI扫描,包括T1WI、T2WI、FLAIR及扩散加权成像,13例患儿行增强扫描。对其中20例发现颅脑局限性病灶患儿的MRI表现进行分析,包括病灶的部位、分布、大小及MRI影像特点。结果:20例发现颅脑局限性病灶,均为多发。病灶主要累及两侧顶枕叶皮层下白质,3例累及顶枕叶皮层和基底节区,呈对称性分布15例,非对称性分布5例。病灶最大径13mm,最小径3mm。于T1WI上呈低信号、T2WI上呈高信号、FLAIR图像上呈高信号者12例;于T1WI上呈等信号、T2WI上呈稍高信号、FLAIR图像上呈稍高信号者8例。DWI上呈较低及等信号、ADC图上呈较高信号12例,DWI上呈等信号、ADC图上呈稍高信号8例。所有局限性病灶均无强化。20例患儿对症治疗7～10d后复查MRI,14例患儿病灶完全消失,6例局限性病灶总数量由18个减少至10个,病灶最大径由平均8mm缩小至4mm,局限性病灶于T2WI和FLAIR图像上信号强度均较前减低。结论:结合患儿病史,MRI不仅能依据其典型表现对儿童尿毒症脑病作出明确诊断,而且在鉴别诊断、临床治疗后转归及预后评估等方面均具有重要的临床应用价值。
Objective：To discuss the magnetic resonance imaging （MRI） diagnosis and differential diagnosis of uremic encephalopathy in children. Methods： Brain MR scanning was performed in 28 pediatric patients with uremic encephalopa thy,the sequences including T1 WI, T2 WI, fluid-attenuated inversion recovery （FLAIR） and diffusion-weighted imaging （DWI）. Enhanced scan was performed in 13 patients. The MRI manifestations of 20 patients with focal brain lesions were analyzed, including the position, distribution, size and MRI features. Results： Of the 20 pediatric patients having focal brain lesions,all of which were multiple,mainly involving subcortical white matter in bilateral parietal-occipital lobes,while 3 ca-ses involving parietal-occipital cortex and basal ganglia. 15 cases showed symmetric and 5 cases asymmetric distribution. The largest diameter of brain lesion was 13mm and the smallest was 3mm. The lesions showed low signal intensity on T, WI, high signal on T2WI,high signal on FLAIR （12 cases）;iso signal intensity on T1WI,slightly high signal on T2WI and slightly high signal on FLAIR （8 cases）. In 12 cases,DWI demonstrated slightly low-and iso signal intensity and on ADC maps the lesions were revealed as high signal;In 8 cases,DWI demonstrated iso-signal intensity and on ADC maps the le sions were revealed as slightly high signal. None of the focal lesions was enhanced. Follow-up MRI 7~lOd after treatment of these 20 pediatric patients,showed completely disappearance of brain lesions in 14 patients, the number of lesions reduced from 18 to 10 in 6 patients. The average of the largest diameter of lesion was reduced from 8mm to 4mm and the signal in tensity of lesions was lower than before on T2 WI and FLAIR. Conclusion：In combination with the clinical history, MRI not only can give a definite diagnosis of uremic encephalopathy in pediatric patients according to their typical features, but also can play an important role in differential diagnosis, evaluation of outcome after treatment an
出处
《放射学实践》
2013年第7期750-754,共5页
Radiologic Practice
关键词
儿童
尿毒症
脑病
磁共振成像
肾功能异常
脑疾病
Children
Uremic encephalopathy
Magnetic resonance imaging
Dysfuetion,renal
Brain diseases
