摘要
目的探讨EV71病毒致中枢神经系统并发症的MRI影像学特点及病情评估。方法回顾性分析2013年5月至2016年6月安徽省儿童医院PICU收治的34例EV71型感染合并中枢神经系统并发症患儿的临床和MRI影像资料,所有患儿都进行MRI扫描。结果在34例中有16例患儿脑和脊髓MRI有异常表现,阳性率47.1%(16/34),单发病灶者6例,多发病灶者10例。在10例MRI阳性的脑干脑炎患儿中,病变位于脑桥6例,延髓3例,中脑1例,在MRI图像上均表现为单侧或双侧片状长T1、略长T2信号,FLAIR和DWI序列呈高信号。在4例MRI阳性的病毒性脑炎患儿中,病变位于大脑皮层2例,位于丘脑2例,呈片状长T1长T2信号,FLAIR和DWI序列呈高信号,并伴有蛛网膜间隙增宽和轻度脑积水。在2例MRI阳性的AFP患儿中,病变位于颈髓(C3-6)1例,位于圆锥1例,表现为单侧或双侧脊髓前角长T1长T2信号,FLAIR和DWI序列呈高信号。结论 EV71感染合并CNS并发症首位为脑干脑炎,其MRI表现具有一定特征性,可以清楚的显示病变部位、形态及范围,有助于评估病变范围及程度,对该疾病的早期诊断、治疗方案的选择具有重要意义。
Objective To study the characteristics of Magnetic Resonance Imaging（MRI）and clinical significance in evaluating the severity of EV71 related neurological complications in children.Methods The clinical data and MRI appearance of 34 patients with EV71 related neurological complications in our hospital between May 2013 to June 2016 were analyzed retrospectively.All patients were performed MRI scan.Results In 34 cases,there are 16 cases have abnormal lesions in MRI.The positive rate of MRI was 47.1%.6cases show single lesion,10 cases show multiple lesions in MRI.In 10 cases of brain stem encephalitis,long T1 and long T2 signal intensity was seen in unilateral or bilateral of pons（6cases）,medulla oblongata（3cases）,and midbrain（one case）,FLAIR and DWI sequence show high signals.In 4cases of viral meningitis,patchy long T1 and long T2 signal intensity was seen in cerebral cortex（2cases）and thalamus（2cases）,with widening of the subarachnoid space,and hydrocephalus may be observed.FLAIR and DWI sequence show high signals.In 2cases of Acute flaccid paralysis,ong T1 and long T2 signal intensity was seen in the unilateral or bilateral anterior horns of cervical cord（one case）and conus medullaris（one case）.Conclusion The predominant neurological complication of EV71 infectde is brainstem encephalitis,they have typical MRI findings.MRI can clearly show site,shape and scope of the lesions,and help to assess the extent and degree of this disease.MRI has great significance in the early diagnosis and treatment of EV71 related neurological complications.
作者
许愿愿
金丹群
孙静敏
李敏
张乐
王昶
Xu Yuanyuan Jin Danqun Sun Jingmin et al(Pediatric intensive care unit （PICU）, Anhui Provincial Children＇s Hospital, Hefei ,Anhui , 230051, China)
出处
《立体定向和功能性神经外科杂志》
2016年第3期155-158,共4页
Chinese Journal of Stereotactic and Functional Neurosurgery
关键词
EV71
中枢神经系统
磁共振成像
儿童
Enterovirus 71
Central Nervous System（CNS）
Magnetic resonance imaging（MRI）
Children
