小儿化脓性脑膜炎头部磁共振成像研究

A clinical study of magnetic resonance imaging in pediatric purulent meningitis

目的了解小儿化脓性脑膜炎（化脑）不同分期的磁共振成像（MRI）表现及动态变化，探讨MRI在化脑诊治方面的应用价值。方法诊断的化脑患儿中，按头部MRI至少检查2次的标准，共选出9例患儿，对其临床资料及不同分期头部MRI成像结果进行回顾性分析。结果4例头部MRI检查结果正常，5例头部MRI检查结果异常。依据不同分期头部MRI的动态变化诊断出脑梗死、脑软化、脑积水、硬膜下积液、硬膜下积脓及硬膜下与硬膜外出血等并发症及合并症。结论MRI不同分期表现能反映化脑患儿头部并发症情况，同时反映出上述病变的发展变化。化脑患儿临床病情轻重与头部MRI结果不平行，其病情严重度评价应结合临床表现及头部MRI等进行综合分析。

Objective To investigate the changes of head magnetic resonance imaging （MRI） in different periods of pediatric purulent meningitis, and to evaluate their values in this kind of disease. Methods Nine cases were selected by the criteria that each patient was examined by MRI not less than two times. Their clinical data and MRI results were reviewed. Results Four cases of MRI were abnormal, 5 cases of MRI were normal. According to the changes of MRI in different period of the disease, we diagnosed complications of pu- rulent meningitis such as cerebral infarction, encephalomalacia, hydrencephaly, subdural effusion, subdural empyema, subdural and extradural hemorrhage. Conclusion MRI examination in different periods of purulent meningitis is effective in detecting the cerebral complications and pathologic changes of purulent meningitis. Because of disagreement between patient＇s conditions and MRI results, we should combine the clinical manifestation with MRI finding to evaluate the severity of purulent meningitis.