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目的探讨小儿病毒性脑炎磁共振成像(MRI)及磁共振弥散加权成像(DWI)的早期表现和临床应用价值。方法收集29例病毒性脑炎患儿的MRI及DWI资料,回顾性分析MRI早期表现,比较病灶与对侧正常脑组织的ADC值差异。结果小儿病毒性脑炎均为多发病灶,多位于大脑半球皮层及皮层下区,多累及颞叶、额叶和顶叶等,呈斑点状或斑片状异常信号。常规MRI序列和DWI显示病灶18例,Flair和DWI显示病灶8例,仅DWI显示病灶3例;T1WI呈稍低信号,T2WI及FLAIR呈稍高信号,DWI呈稍高或高信号。29例的DWI均发现病灶;ADC呈稍低信号,患侧ADC均值较对侧正常脑组织低。结论小儿病毒性脑炎的MRI早期表现有一定特征,DWI能早期发现病灶,对小儿病毒脑炎的早期诊断有重要价值。
Objective To investigate the early manifestation and clinical value of viral encephalitis in children with MRI and diffusion weighted imaging (DWI). Methods The MRI and DWI data of 29 children with viral encephalitis were collected. The MRI findings were retrospectively analyzed. The difference of ADC value between the lesion and the contralateral normal brain tissue was compared. Results Children with viral encephalitis are multiple lesions, mostly in the cerebral cortex and subcortical area, involving the temporal lobe, frontal lobe and parietal lobes, etc. were spotted or patchy abnormal signal. Conventional MRI and DWI showed lesions in 18 cases, Flair and DWI showed lesions in 8 cases, only DWI showed lesions in 3 cases; T1WI was slightly lower signal, T2WI and FLAIR was slightly higher signal, DWI was slightly higher or higher signal. 29 cases of DWI were found lesions; ADC was slightly lower signal, ipsilateral ADC mean normal contralateral contralateral brain tissue is low. Conclusion The early manifestations of MRI in children with viral encephalitis have certain characteristics. DWI can detect the lesions early and is of great value in the early diagnosis of viral encephalitis in children.