儿童Blake’s囊肿的磁共振征象分析

A Prospective Analysis of Magnetic Resonance Imaging Findings in Children Patients with Blake's Pouch Cyst

目的 分析Blake’s囊肿（BPC）的磁共振表现,提高对该病的诊断水平。方法 搜集2008年5月至2016年5月10例BPC患儿资料,男4例,女6例;年龄2个月-6岁,平均14个月。10例头围均增大,其中颅缝增宽5例,前囟饱满3例,2例前囟张力高。生后嗜睡、频繁呕吐、拒奶,瞳孔对光放射迟钝2例;双下肢肌张力增高7例;语言发育滞后、步态失调2例;反复头晕1例。10列均行头颅MRI检查。结果 10例均显示小脑后下方囊肿伴中、重度脑积水,囊状扩张四脑室与囊肿直接交通;矢状位小脑蚓部下方受压改变,轴位示小脑半球间隙增宽,半球内侧对称性压迹;患儿小脑幕及窦汇位置正常;小脑蚓部完整,位置正常8例,轻度上旋2例;6例患儿扫描T2WI矢状位均显示囊肿后壁,其中3例显示下移的第四脑室脉络丛。结论 MRI有助于BPC的诊断,评估中枢神经系统发育异常,应作为BPC首选的检查和诊断方法。

Objective To analyse magnetic resonance performance of Blaket cyst （BPC）, and to improve the accuracy of diagnosis in BPC disease. Methods From 2008.5 to 2016.5, ten children were enrolled in this study including 4 males and 6 females （aged from 2 months to 6 years, average age 14 months）. Ten cases all manifested with increased head circumference （ Sutures widened in 5 cases, full anterior fontanelle in 3 cases and 2 cases with increased tension of anterior fontanelle）. Two eases clinically manifested with lethargy, vomiting, refusal to drink milk and slow pupillary light reflex. Seven patients manifested with increased muscle tension in either lower extremities, 2 cases with language development delay and gait disorders and 1 ease with repeated dizziness. All 10 eases were underwent an MRI scan investigation. Results All patients had dilatation of the fourth ventricle, cyst below the cerebellar vermis and hydrocephalus. The cerebellar vermis was pushed on sagittal images and the gap of eerebellar hemisphere was widened on axial images. Eight patients with bilateral normal development of the cerebellar hemispheres in all 10 patients, but 2 cases were associated with the rotated upward cerebellar vermis. Cyst＇ s rear wall could be shown in 6 cases on T2W sagittal images. The displacement of the fourth ventricle choroid plexus was manifesed in 4 patients. Conclusion MRI was helpful in the diagnosis of BPC and evaluation of abnormal development of the central nervos system. MRI scanning should he the first choice of imaging investigation.