婴幼儿脑外间隙增宽的影像表现及其临床意义

The Clinicial Meaning of CT、MR Manifestion in Infants with Extracerebral Space Enlargement

目的：探讨婴幼儿脑外间隙增宽的临床意义。方法：CT、MR表现为脑外间隙增宽的婴幼儿48例，对其病因、临床表现及预后进行回顾性分析。结果：CT、MR单纯表现为脑外间隙增宽，无其他脑部异常者39例，其中9例患儿无相关临床症状，8例患儿仅表现头围偏大；20例患儿表现部分中枢性协调障碍症状；脑膜炎2例，合并其他脑部器质性者9例：其中脑室旁白质软化3例，脑积水2例，脑出血2例，脑先天畸形2例，临床全部表现脑瘫。结论：婴幼儿脑外间隙增宽可分生理性和病理性增宽，对于无相关临床症状或仅头围偏大者，考虑为婴幼儿期脑快速发育的生理性表现；对于有明确临床症状及病史而CT、MR未发现脑部器质性病变者，可认为是脑发育落后的一种表现；对于合并脑部器质性病变者，脑外间隙增宽通常为继发性改变。

Objective To assess the clinicial meaning of extracerebral space enlargement in infants. Methods Review and analyse the cause clinicial manifestation and prognosis of 48 Infants whose CT and MR show extracerebral space enlargement. Results There are 39 patiants have extracerebral space enlargement without abnormal in brains, In these cases ,9 patients have no clinicial symptoms,8 cases have head circumference enlargement. There are 20 patients have central clystaxia,2 patients have meningitides. 9 patients have other cerebral lesion： 3 case periventricular white matter malacia,2 cases hydrocephalus,2 cases brian hemorrhage,2 cases congenital malformation in cerebrals. All these patients express cerebral palsy. Conclusion Extracerebral space enlargement in infants can be divided into physiology and pathology. The infants with head circumference enlargement only will be considered physiological manifestation because of the fast development in cerebrums. Extracerebral space enlargement in infants with clear clinicial symptoms medical history and without other abnormal in CT or MR will be considered to be one manifestation of developing slowly in cerebrums. Extracerebral space enlargement usually to be secondary manifestation in patients with other brian pathologic lesion.