论文部分内容阅读
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 investigate the MRI features and assessment of the complications of CNS caused by EV71 virus. Methods The clinical and MRI images of 34 children with EV71 infection complicated with central nervous system complications admitted to PICU of Children’s Hospital of Anhui Province from May 2013 to June 2016 were retrospectively analyzed. All children underwent MRI scan. Results MRI was abnormal in brain and spinal cord in 16 of 34 children. The positive rate was 47.1% (16/34). There were 6 single lesions and 10 multiple lesions. In 10 cases of MRI-positive children with encephalitis, the lesions were located in 6 cases of pontine, 3 cases of medulla oblongata and 1 case of midbrain. All of them showed unilateral or bilateral lamellar long T1, slightly longer T2 signal , FLAIR and DWI sequences showed high signal. In 4 cases of MRI-positive children with viral encephalitis, the lesions located in the cerebral cortex in 2 cases, located in the thalamus in 2 cases, flaky long T1 long T2 signal, FLAIR and DWI sequence was high signal, accompanied by increased arachnoid space Wide and mild hydrocephalus. In 2 cases of AFP-positive AFP, the lesions were located in the cervical spinal cord (C3-6) in 1 case, located in the cone in 1 case, showed unilateral or bilateral spinal anterior horn long T1 long T2 signal, FLAIR and DWI sequence was high signal. Conclusions The first complication of EV71 infection complicated with CNS is brainstem encephalitis. The MRI manifestations of EV71 infection have certain characteristics, which can clearly show the location, shape and scope of the lesion. It is helpful to evaluate the extent and extent of the lesion, and to diagnose and treat the disease The choice of program is of great importance.