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目的探讨重症手足口病并脑干脑炎的MRI表现及临床特征。方法收集2010年3-5月确诊为手足口病并脑干脑炎的患儿29例,对其MRI与临床资料进行回顾性分析。结果 29例患儿MRI表现:阴性25例,阳性4例,病灶均局限在脑桥和延脑交界部,2例病灶为脑桥、延脑交界处对称性向两侧延伸,2例病灶非对称性向两侧延伸。信号特征均呈斑片状T1加权像(T1WI)略低信号、T2加权像(T2WI)略高信号,边界不清。随访10 d~2个月,脑桥和延脑交界部病灶逐渐变小,长T1、长T2信号改变更显著,边界逐渐清晰。临床特征:29例患儿均有发热和皮疹;神经系统症状中,肢体震颤29例(100%),眼球运动异常(游动或上翻)23例(79.3%),烦躁和惊恐16例(55.2%),行走不稳12例(41.4%);MRI阳性4例患儿有神经系统后遗症,25例阴性患儿无神经系统后遗症。结论重症手足口病并脑干脑炎的MRI与临床表现具有一定关系,MRI能真实显示其脑干脑炎脑部受损情况及病变发展变化,能为临床诊断、治疗及预后提供可靠的影像学依据。
Objective To investigate the MRI features and clinical features of severe hand-foot-mouth disease and brainstem encephalitis. Methods Totally 29 children with hand-foot-mouth disease and brainstem encephalitis diagnosed from March to May in 2010 were collected. The MRI and clinical data were retrospectively analyzed. Results The MRI findings of the 25 cases were negative in 25 cases and positive in 4 cases. The lesions were confined to the junction of pons and medulla oblongata. Two lesions were pontine. The symmetry of the medulla oblongata extended to both sides. Side extension. Signal characteristics were patchy T1 weighted image (T1WI) slightly lower signal, T2 weighted image (T2WI) slightly higher signal, the border is unclear. During the follow-up of 10 days to 2 months, the lesion in the junction of pons and medulla oblongata gradually became smaller, the changes of long T1 and long T2 signals were more obvious, and the border became clear gradually. Clinical Features: All 29 patients had fever and rash. In neurological symptoms, limb tremor was found in 29 (100%), ocular motility (palpitation or supination) in 23 (79.3%), irritability and panic in 16 55.2%), unstable walking in 12 cases (41.4%); MRI-positive children with neurological sequelae in 4 cases, 25 cases of negative children without neurological sequelae. Conclusions MRI in patients with severe HFMD and encephalic encephalitis has some relationship with clinical manifestations. MRI can show the brain damage and the development of encephalopathy encephalitis, which can provide reliable images for clinical diagnosis, treatment and prognosis Learn from.