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目的探讨磁共振脑膜强化模式在婴幼儿颅内感染诊断中的应用价值,为临床诊治提供参考依据。方法选取2013年7月-2014年6月医院收治的76例经脑脊液检查确诊的颅内感染婴幼儿,所有患儿均经T1WI增强扫描以及磁共振常规平扫,脑膜强化共有4级,观察分析所有婴幼儿磁共振脑膜强化的影像学表现。结果磁共振检查中,12例(15.79%)化脓性脑膜炎有10例(83.33%)表现为全脑膜强化;28例(36.84%)例病毒性脑膜炎中有8例(28.57%)表现为软脑膜可疑过度强化,9例(32.14%)表现为蛛网膜-软脑膜强化,5例(17.86%)表现为全脑膜强化级;21例(27.63%)结核性脑膜炎有13例(61.90%)表现为脑基底池异常强化;15例(19.74%)其他感染中4例(26.67%)表现为脑基底池异常强化,1例(6.67%)表现为软脑膜可疑过度强化,2例(13.33%)表现为蛛网膜-软脑膜强化;增强后12例化脓性脑膜炎,10例(83.33%)为Ⅰ级,2例(16.67%)为Ⅲ级;28例病毒性脑膜炎中14例(50.00%)为0级,9例(32.14%)Ⅱ级,5例(17.86%)Ⅲ级;21例结核性脑膜炎中7例(33.33%)为0级,1例(4.76%)Ⅱ级,13例(61.90%)Ⅲ级;15例其他感染中8例(53.33%)0级,1例(6.67%)Ⅰ级,6例(40.00%)为Ⅱ级。结论婴幼儿具有较为丰富的软脑膜表面毛细血管,仅仅依靠软脑膜轻中度强化,难以作为颅内感染的可靠征象,再加之婴幼儿颅内感染早期病理变化较为轻微,因此在确诊中需要和临床诊断相互结合。
Objective To investigate the value of magnetic resonance meningeal enhancement in the diagnosis of intracranial infection in infants and young children, and to provide a reference for clinical diagnosis and treatment. Methods From July 2013 to June 2014, 76 children with intracranial infection confirmed by cerebrospinal fluid examination were enrolled in the hospital. All children underwent enhanced T1WI scan and conventional magnetic resonance plain scan. There were 4 meningeal enhancement stages. The observation and analysis Imaging manifestations of MRI in all infants and young children. Results In the MR examination, 10 cases (83.33%) of 12 cases (15.79%) of purulent meningitis showed full meningeal enhancement and 8 (28.57%) of 28 cases (36.84%) of viral meningitis showed Five cases (17.86%) manifested as full meningeal enhancement in nine cases (32.14%), thirteen cases (61.90%) in 21 cases (27.63%) had tuberculous meningitis, ) Showed abnormal enhancement of basilar pool; 4 (26.67%) of 15 other cases (19.74%) showed abnormal enhancement of basilar pool, 1 case (6.67%) showed suspicious enhancement of pia mater, %) Manifested as arachnoid-pial enhancement; enhancement of 12 cases of purulent meningitis, 10 cases (83.33%) of grade Ⅰ, 2 cases (16.67%) Ⅲ grade; 28 cases of viral meningitis in 14 cases 50.00%) were grade 0, 9 (32.14%) were grade Ⅱ and 5 (17.86%) were grade Ⅲ. Among the 21 patients with tuberculous meningitis, 7 (33.33%) were grade 0 and 1 , 13 cases (61.90%) were grade Ⅲ; 8 cases (53.33%) were 0 cases in other 15 cases, 1 case (6.67%) were grade Ⅰ and 6 cases (40.00%) were grade Ⅱ. Conclusion Infants and young children have more abundant leptomeningeal surface capillaries, relying only on mild to moderate enhancement of the pia mater, it is difficult as a reliable sign of intracranial infection, combined with early childhood pathological changes in intracranial infection in infants and young children less so in the diagnosis of need and Clinical diagnosis combined with each other.