CAJ | 학술논문

目的探讨小儿流行性乙型脑炎(乙脑)的临床特点与颅脑MRI影像特征及其与预后的关系,为临床早期诊治提供依据.方法回顾性分析本院收治的145例流行性乙型脑炎患儿的临床及MRI资料.98例行0.35 T MRI检查获得常规T1WI、T2WI及FLAIR序列,47例行1.5 T MRI检查除采集常规序列外,还采集了DWI序列.分析脑部MRI表现:病灶累及的部位、范围和MRI信号特征.结果 MRI平扫中106例(73.1%)发现脑实质异常信号影,其病灶不同程度的累及丘脑,87例同时累及中脑大脑脚,同时累及基底节、脑皮质及小脑受累分别为32例、43例和2例;15例累及脑白质.病灶表现为不同范围的T2WI高信号病变,T1WI多呈低信号,少数呈等信号.FLAIR上全部可见高信号灶,少数高信号灶中心可见低信号影.38例FLAIR显示脑实质异常信号灶较T2WI更多.DWI上28例可见脑实质高信号病灶,12例可见低信号病灶,7例在DWI及ADC图均呈等信号改变.1.5 T MRI阳性率(87.2%)明显高于0.35 T MRI(66.3%,χ2＝7.06,P＜0.01).结论 MRI能显示乙脑患儿颅脑病变的部位及范围,累及丘脑及中脑大脑脚为其特征性表现.FLAIR及DWI对乙脑的早期诊断具有很高的价值.
목적 탐토소인류행성을형뇌염(을뇌)적림상특점여로뇌MRI영상특정급기여예후적관계,위림상조기진치제공의거.방법 회고성분석본원수치적145례류행성을형뇌염환인적림상급MRI자료.98례행0.35 T MRI검사획득상규T1WI、T2WI급FLAIR서렬,47례행1.5 T MRI검사제채집상규서렬외,환채집료DWI서렬.분석뇌부MRI표현:병조루급적부위、범위화MRI신호특정.결과 MRI평소중106례(73.1%)발현뇌실질이상신호영,기병조불동정도적루급구뇌,87례동시루급중뇌대뇌각,동시루급기저절、뇌피질급소뇌수루분별위32례、43례화2례;15례루급뇌백질.병조표현위불동범위적T2WI고신호병변,T1WI다정저신호,소수정등신호.FLAIR상전부가견고신호조,소수고신호조중심가견저신호영.38례FLAIR현시뇌실질이상신호조교T2WI경다.DWI상28례가견뇌실질고신호병조,12례가견저신호병조,7례재DWI급ADC도균정등신호개변.1.5 T MRI양성솔(87.2%)명현고우0.35 T MRI(66.3%,χ2＝7.06,P＜0.01).결론 MRI능현시을뇌환인로뇌병변적부위급범위,루급구뇌급중뇌대뇌각위기특정성표현.FLAIR급DWI대을뇌적조기진단구유흔고적개치.
Objective The purpose of this study was to investigate the clinical features and the magnetic resonance imaging of brain of children with Japanese encephalitis (JE) and whether this relationship can be used in early diagnosis.Methods MRI was performed in 145 children with JE.T1-weighted,T2-weighted and FLAIR of brain were obtained in 98 patients with 0.35 T MRI system and conventional MRI and DWI were performed in 47 patients with 1.5 T MRI system.The position,range and MRI features were analyzed.Results MR imaging studies of 106 patients showed hyperintensity in the thalamic with 87 patients involved the caudex cerebri,as seen on T2-weighted images.The lesions were also seen in basal ganglia (32 cases),cerebral cortex (43 cases),cerebellum (2 cases),and white matter (15 cases).Lesions showed high intensity signal on T2WI and T2-FLAIR,and iso- or low intensity on T1WI.The number of the lesions in FLAIR were more than T2WI.The positive rate on 1.5 T MRI (87.2%) was higher than that on 0.35 T MRI(66.3%,χ2＝7.06,P＜0.01).Conclusions Multiple brain tissues can be involved and the thalamic and the caudex cerebri involvement are the conspicuous characteristics in children with JE.T2-FLAIR and DWI are helpful in the early diagnosis of JE.