CAJ | 학술논문

目的：探讨肠道病毒71型感染手足口病（HFMD）合并急性弛缓性麻痹（AFP）的临床及MRI表现。方法搜集2010年05月～2011年010月EV71感染 HFMD合并AFP的患儿13例，分析其临床表现及脊髓MRI特征。结果13例患儿中，表现为单侧下肢瘫痪6例，双下肢瘫痪2例，单侧上肢瘫痪2例，一侧肢体偏瘫1例，双侧上肢瘫痪1例，肢体交叉瘫痪1例，表现为左上肢及右下肢瘫痪。M RI表现为矢状面脊髓内长条形等或长 T1、长 T2信号，横断面显示相应节段脊髓前角圆点状长T2信号；下胸段至腰骶段脊髓前角受累8例，颈段脊髓5例，受累范围3个椎体及以上9例；单侧受累1例，双侧受累12例，其中对称性病变3例，不对称9例。5例颈段脊髓病变中有4例合并脑干脑炎，病变以脑桥、延髓交界部为主，呈长T1长T2信号。M RI表现与临床表现具一致性，脊髓前角病变引起所支配的上肢和（或）下肢肌群的急性弛缓性麻痹。结论 M RI检查是诊断 H FM D合并急性弛缓性麻痹的首选的影像检查方法，损害部位位于脊髓前角，以下胸段至腰骶段脊髓及颈段脊髓常见，影像学表现与临床表现具有一致性。
목적：탐토장도병독71형감염수족구병（HFMD）합병급성이완성마비（AFP）적림상급MRI표현。방법수집2010년05월～2011년010월EV71감염 HFMD합병AFP적환인13례，분석기림상표현급척수MRI특정。결과13례환인중，표현위단측하지탄탄6례，쌍하지탄탄2례，단측상지탄탄2례，일측지체편탄1례，쌍측상지탄탄1례，지체교차탄탄1례，표현위좌상지급우하지탄탄。M RI표현위시상면척수내장조형등혹장 T1、장 T2신호，횡단면현시상응절단척수전각원점상장T2신호；하흉단지요저단척수전각수루8례，경단척수5례，수루범위3개추체급이상9례；단측수루1례，쌍측수루12례，기중대칭성병변3례，불대칭9례。5례경단척수병변중유4례합병뇌간뇌염，병변이뇌교、연수교계부위주，정장T1장T2신호。M RI표현여림상표현구일치성，척수전각병변인기소지배적상지화（혹）하지기군적급성이완성마비。결론 M RI검사시진단 H FM D합병급성이완성마비적수선적영상검사방법，손해부위위우척수전각，이하흉단지요저단척수급경단척수상견，영상학표현여림상표현구유일치성。
Objective To explore the features of clinical manifestations and spinal MR images of acute flaccid paralysis associated with enterovirus 71 infected hand-foot-mouth disease (HFMD) .Methods Clinical characteristics and MRI fea-ture of 13 children with EV 71 combined myelitis were retrospectively reviewed .Results Acute paralysis was observed in unilateral lower limb in 6 of 13 patients ,in both lower limb in 2 patients ,in unilateral upper limb in 2 patients ,in unilater-al upper and louwer limb in 1 patient ,in both upper limb in 1 patient ,in the left upper limb and right lower limb in 1 pa-tient .MR studies showed the hypointensity or isointensity on T1WI and hyperintensity on T2WI in the anterior horn re-gions of the spinal cord on sagital and transwers image ,the lesions at the anterior horn level in the lower thoracic to lum-bosacral segment of the cord were seen in 8 patients ,the lesions in the cervical segment of the cord were seen in 5 patients . Of the 13 patents ,1 showed unilateral anterior horn regions lesions ,12 showed bilateral lesions .Four of five patents with cervical lesions combined with brainstem encephalitis ,the lesion of brainstem lied at the bondary of medulla oblongata and pond .MR imaging finding of EV71 myelitis and its clinical manifestations had good correlation .Conclusion MRI is the preferential choice for the diagnosis of EV71 combined acute flaccid paralysis ,It can provide reliable imaging imfomation for physicion .The leasions tends to be in lower thoracic to lumbersacral segment and cervical segment of the cord and spe-cifically involves the anterior of the cord .