摘要
目的:回顾性分析小儿重症手足口病(HFMD)并发脑干脑炎的MRI表现,探讨DWI的诊断价值。方法:回顾性分析130例经临床及MRI确诊为HFMD并发脑干脑炎的患儿资料,所有患儿均在发病一周内行MRI检查,均应用扩散加权成像,分析DWI、ADC图,同时测感兴趣区表观弥散系数(ADC)。结果:130例患儿头颅MRI平扫病灶位于脑干背侧,83例以血管源性水肿为主,DWI呈等或略高信号,ADC值正常或升高,T2WI及T2 FLAIR呈均匀高信号,DWI检出率明显不如常规序列。40例DWI显示细胞毒性水肿,表现脑干背侧对称斑片高亮信号,ADC值下降,对病灶范围、信号强度的显示优于常规序列,其中DWI单独显示6例。7例为以上两种表现共存,DWI与常规序列显示病灶能力相仿。结论:小儿重症手足口病并发脑干脑炎好发脑干背侧,DWI对细胞毒性水肿病灶的检出率较高。
Purpose：To investigate the MRI appearances of brainstem encephalitis in children with severe handfoot-mouth disease（HFMD）, and to explore the diagnostic value of diffusion weighed imaging（DWI）. Methods：The data of 130 cases brainstem encephalitis in children with HFMD confirmed by clinic and MRI were retrospectively reviewed. All the patients were undergone DWI in one week after the onset of HFMD, the appearances of DWI images and ADC maps were analyzed and ADC values of the lesions were calculated. Results： All the lesions were located in posterior portions of the brainstem. Vasogenic edema was shown on DWI in 83 cases. The signal of them were displayed as iso-intense or slight hyper-intense on DWI and hyper-intense on T2 WI and T2 FLAIR, the ADC values were normal or high. DWI was obviously inferior to routine sequences in identification of this kind of lesions. Cytotoxic edema was shown on DWI in 40 cases. The signal of them were displayed as symmetric spot-like hyperintense signal on DWI in posterior portions of the brainstem, the ADC values were decreased, six of these cases were only shown on DWI. DWI was obviously superior to routine sequences in identification of this kind of lesions. Both two kinds of edema were coexisted in 7 cases,DWI was similar to routine sequences in identification of this kind of lesions. Conclusion：Brainstem encephalitis in children with seveve HFMD mainly located in posterior portions of the brainstem. DWI has obvious ascendancy in detection of cytotoxic edema lesion.
出处
《中国医学计算机成像杂志》
CSCD
北大核心
2016年第1期13-16,共4页
Chinese Computed Medical Imaging
关键词
手足口病
重症
脑干脑炎
磁共振成像
扩散加权成像
Hand
foot and mouth disease
Severe
Brainstem encephalitis
Magnetic resonance imaging
Diffusion weighted imaging
