儿童甲型H1N1流感并急性坏死性脑病的CT及MRI表现

CT and MRI appearance of acute necrotizing encephalopathy caused by children A H1N1 influenza

目的探讨儿童甲型H1N1流感并急性坏死性脑病（ANE）的CT及MRI表现。方法分析经过临床实验室检查确诊的3例儿童甲型H1N1流感并ANE患者的颅脑CT及MRI影像表现。各患儿住院期间均因昏迷而行颅脑CT及MRI扫描。结果3例儿童甲型H1N1流感并ANE的颅脑CT及MRI影像表现为多灶性、部分对称性脑部损害，以累及双侧丘脑为共同点；双侧大脑半球额、颞、顶、枕叶灰白质，海马区、豆状核、外蜒、脑干及双侧小脑半球灰白质多灶性、部分对称性脑部损害，并以灰质损害为主；不同程度脑肿胀。病变区CT表现为密度减低；MRI呈长T1、长T2信号，FLAIR系列呈较高信号.结论儿童甲型H1N1流感并ANE影像表现为脑内多灶性、部分对称性脑部损害及脑水肿，影像学以累及双侧丘脑为特征，病情严重，病死率极高，临床应予以高度重视。

Objective To evaluate the imaging features of acute necrotizing encephalopathy caused by children A H1 N1 influenza. Methods CT and MRI brain imaging data of three children acute necrotizing encephalopathy caused by A H1 N1 influenza virus and proved by clinical and laboratory investigation were analyzed. All the three children got CT and MRI scan because of coma while in hospital. Results All cases represented muhifocal damage, and some were symmetrical.Bilateral thalanlencephalons were involved in the all cases. Bilateral grey and white matters of frontal lobe,temporal lobe, parietal lobe and occipital lobe, and hippocampi, putamina, external capsule, brain stere,bilateral cerebellum, could be seen muhifocal damage, and some were symmetrical. All the cases showed brain swelling in varying degrees. These region presented low density in CT, hypointensity on T1 weighted series and hyperintensity on T2 weighted series anti FLAIR series in MRI. Conclusion The imaging features of acute necrotizing encephalopathy caused by ctfildren A H1 N1 influenza represented muhifocal and symmetrical damage and brain swelling. It may be characteristic that b/lateral thalamencepbalons were invoh,ed. The patient was serlous,and fatality rate was high. So we should pay much attention to acute necrotizing encephalopathy caused by children A HI Nl influenza.