CAJ | 학술논문

目的：分析小儿重症手足口病（HFMD）并发脑炎的MRI平扫表现及特征。资料与方法回顾性分析85例经临床确诊为HFMD并发脑炎患儿的颅脑MRI资料。结果85例患儿头颅MRI平扫阴性28例，阳性57例，其中10例为斑点或片状病灶散在分布于大脑半球、胼胝体、丘脑及小脑蚓部，呈稍长或等T1、稍长或等T2信号，T2FLAIR、DWI多数呈高信号。47例病灶位于脑干，以桥脑被盖部及延髓为主，其中17例DWI见脑干被盖部呈对称斑片状高亮信号，T1WI呈低信号或等信号，T2WI及T2FLAIR呈高信号或等信号；30例表现为脑干背侧片状长T1、稍长T2信号，DWI呈等或略高信号，T2FLAIR呈高信号，9例病变对称性向四脑室周围延伸，其中1例累及两侧大脑脚。结论小儿HFMD并发脑炎的MRI表现有一定特征性，病变以脑干被盖部为主；DWI及T2FLAIR序列可提高病灶的检出率。
목적：분석소인중증수족구병（HFMD）병발뇌염적MRI평소표현급특정。자료여방법회고성분석85례경림상학진위HFMD병발뇌염환인적로뇌MRI자료。결과85례환인두로MRI평소음성28례，양성57례，기중10례위반점혹편상병조산재분포우대뇌반구、변지체、구뇌급소뇌인부，정초장혹등T1、초장혹등T2신호，T2FLAIR、DWI다수정고신호。47례병조위우뇌간，이교뇌피개부급연수위주，기중17례DWI견뇌간피개부정대칭반편상고량신호，T1WI정저신호혹등신호，T2WI급T2FLAIR정고신호혹등신호；30례표현위뇌간배측편상장T1、초장T2신호，DWI정등혹략고신호，T2FLAIR정고신호，9례병변대칭성향사뇌실주위연신，기중1례루급량측대뇌각。결론소인HFMD병발뇌염적MRI표현유일정특정성，병변이뇌간피개부위주；DWI급T2FLAIR서렬가제고병조적검출솔。
Purpose To investigate MRI features of encephalitis in children with severe hand-foot-mouth disease (HFMD). Materials and Methods The MR images of 85 cases of clinically diagnosed encephalitis in severe HFMD patients were retrospectively reviewed. Results In 85 patients, plain MRI was negative in 28;57 cases were positive including 10 cases showing punctate or patchy lesions in cerebral hemisphere, callosum, thalamus and cerebellar vermis with isointensity or slightly hypointensity on T1WI, isointensity or slightly hyperintensity on T2WI, and hyperintensity on T2FLAIR and DWI. In 47 cases, the lesions were located in the brainstem, tegmentum of pons and medulla oblongata. MRI features included symmetric high signal on DWI in posterior portions of brainstem, hypointensity or isointensity on T1WI and hyperintensity or isointensity on T2WI and T2FLAIR (n=17);patchy long T1, long T2 signal in posterior portions of brainstem, normal or mild hyperintensity on DWI, hyperintensity on T2FLAIR (n=30); lesion extending around the fourth ventricle in 9 patients, one of which involved bilateral cerebral peduncles. Conclusion Encephalitis in children with severe HFMD has characteristic MRI features. The lesions are mostly located in the posterior portion of the brainstem. DWI and T2FLAIR can better detection lesions.