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目的总结儿童伴可逆性孤立胼胝体压部病变轻型脑炎(MERS)磁共振(MRI)表现及临床特点,并分析可能病因。方法回顾总结2012年1月至2014年5月山西省儿童医院7例MERS患儿临床资料及MRI表现,分析其表现及特点。结果 7例患者中男4例、女3例,年龄2~14岁;临床表现包括发热5例(71.4%)、消化道症状6例(85.7%)、睡眠增多4例(57.1%)、抽搐3例(42.9%)、头晕1例(14.2%)、颈抵抗阳性1例(14.2%)。脑脊液常规生化正常。MRI表现均为仅见胼胝体压部正中稍长T1稍长T2信号,DWI呈高信号,ADC图呈低信号。5例呈居中带状,2例呈居中卵圆形。7例患儿经抗感染等对症支持治疗后病情痊愈出院,病程最短8 d,最长19 d。复查MRI示胼胝体压部病变消失。结论儿童MERS临床表现多为发热、消化道症状、睡眠增多或抽搐等,有其特征性MRI表现,属于可逆的细胞毒性水肿,预后良好。
Objective To summarize the MRI findings and clinical features of isolated mild corporis callosum (MERS) in children with reversible isolation and analyze the possible etiology. Methods The clinical data and MRI findings of 7 MERS children from January 2012 to May 2014 in Shanxi Children’s Hospital were reviewed and summarized. The performance and characteristics of MERS were analyzed. Results There were 4 males and 3 females in 7 patients, aged 2-14 years old. The clinical manifestations included fever in 5 (71.4%), gastrointestinal symptoms in 6 (85.7%), sleep increased in 4 (57.1%), convulsions 3 cases (42.9%), 1 case of dizziness (14.2%) and 1 case of cervical resistance (14.2%). Cerebrospinal fluid routine biochemical normal. MRI showed only the middle of the corpus callosum pressure slightly longer T1 signal T2, DWI was high signal, ADC showed low signal. 5 cases were centered in the band, 2 cases were centered oval. Seven cases of children were cured after symptomatic supportive treatment such as infection. The course of disease was discharged for a minimum of 8 days and the longest was 19 days. Review MRI showed corpus callosum pressure lesions disappear. Conclusions Children MERS clinical manifestations are mostly fever, gastrointestinal symptoms, increased sleep or convulsions, etc., has its characteristic MRI manifestations, is a reversible cytotoxic edema, the prognosis is good.