中国实用儿科杂志

中国实用儿科杂志

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重症病毒性脑炎患儿的磁共振影像特点

侯晓君，谢文煌   

  1. 福建医科大学附属第一医院儿科，福建福州 350005
  • 收稿日期:2006-02-07 修回日期:2006-04-04 出版日期:2006-07-06 发布日期:2006-07-06

MRI and clinical analysis of severe viral encephalitis in children.

Hou Xiaojun,Xie Wenhuang.   

  1. Pediatrics Department,the First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China
  • Received:2006-02-07 Revised:2006-04-04 Online:2006-07-06 Published:2006-07-06

摘要： 目的探讨儿童重症病毒性脑炎磁共振(MRI)影像的特点及其临床意义。方法回顾分析福建医科大学附属第一医院2004-06—2005-10经临床确诊的30例儿童重症病毒性脑炎MRI及临床资料，所有病例常规做SE序列：轴位、矢状位T1WI、T2WI，必要时加扫T2WI冠状位；6例加扫弥散加权成像(DWI)。 结果25例MRI影像发现异常，主要表现为T1WI呈稍低或等信号，T2WI呈稍高异常信号，DWI呈明显高信号，表观弥散系数(ADC)值降低。 结论MRI可早期发现病毒性脑炎，是病毒性脑炎影像学检查的首选方法，对病毒性脑炎的定位、早期诊断、病情严重性及预后评价具有重要价值；DWI比T2WI显示病变更清晰且能作定量评价；MRI表现病灶累及范围越广泛，则病情越重，预后越差。

关键词: 病毒性脑炎, 磁共振成像

Abstract: To explore the MRI presentative characteristics of severe viral encephalitis in children and to evaluate its clinical value. MethodsMRI manifestations of 30 patients with severe viral encephalitis confirmed clinically from June 2004 to October 2005 were retrospectively analyzed.The axial and sagittal T1WI，T2WI in all cases were performed routinely,and coronal T2WI was added if necessary.In addition,6 cases were performed diffusion weighted imaging (DWI). ResultsTwentyfive of 30 cases were abnormal.The MRI manifestations of viral encephalitis showed the viral encephalitis had relatively low or equal signal on T1WI and relatively high signal on T2WI，high signal intensity on DWI.The apparent diffusion coefficient(ADC)values dropped. ConclusionMRI can find the viral encephalitis in the early stages and this method should be the first choice for imaging examinations in diagnosis of viral encephalitis.MRI has high value in the diagnosis，evaluation of severity,treatment and followup of the viral encephalitis.Viral encephalitis is shown on DWI better than on T2WI and can be assessed quantitatively by ADC values.The more the extent of the disease involved，the severer the disease and the worse the prognosis.

Key words: Magnetic resonance imaging(MRI)