重症手足口病并发脑脊髓炎的MRI分析

Analysis of MRI Findings of Encephalomyelitis with Hand-Foot-Mouth Disease

目的:探讨重症手足口病并发脑脊髓炎的MRI表现特征,以提高对本病MRI征象的认识。方法:对458例临床诊断为重症手足口病并发脑炎或脊髓炎的患儿进行头颅MRI检查,其中18例同时进行脊髓MRI检查,获得T1WI、T2WI及FLAIR图像,并分析脑部及脊髓MRI表现,重点分析病变的位置、形态及信号特点。结果:458例头颅MRI检查中402例脑实质或脊髓未见异常信号影;56例(12.2%)发现脑部和/或脊髓病灶,其中49例发现脑干异常信号影,11例累及脊髓,其中4例同时累及脑干与脊髓。脑炎病例T2WI均表现为脑干不同程度的高信号改变。脊髓炎病例均呈对称性纵行长条状T2WI高信号影,边缘清晰,横断位脊髓前角可见对称性类圆形病灶。结论:重症手足口病并发脑脊髓炎常累及脑干,易累及脊髓前角,MRI表现具有特征性,矢状面及横断面T2WI序列对脑部及脊髓病变的显示及病变范围评价起重要作用,可对临床治疗提供可靠的影像学依据。

Objective The purpose of this study was to investigate the magnetic resonance imaging features of children who had encephalitis and/or Myelitis with severe hand-foot-mouth disease.Methods MRI was performed in 458 children who had encephalitis and/or Myelitis with severe hand-foot-mouth disease.T1-weighted and T2-weighted MR images of brain and/or spinal cord were obtained and analyzed the MRI performance.Results MR imaging studies of 56 patients showed hyperintensity in the brain stem,as seen on T2-weighted images,and 11 in spinal cord,and 4 involved the brain stem and the spinal cord in all these patients.Conclusion The encephalitis and/or Myelitis with severe hand-foot-mouth disease in children often involves the brain stem and/or the anterior of spinal cord,the MRI performance has characteristic findings.It may provide reliable radiology information for physicians.