儿童斯特奇-韦伯综合征计算机断层扫描与磁共振成像对照研究

Comparison of CT and MRI images in childhood Sturge-Weber syndrome

目的:回顾性分析36例3 d～11岁斯特奇-韦伯综合征(SWS)患儿计算机断层扫描(CT)和磁共振成像(MRI)影像学表现。方法:收集该院36例SWS患儿,其中34例予CT扫描,29例予MRI检查,27例同时予CT及MRI检查。其中CT增强扫描1例,MRI增强扫描3例。结果:36例患儿中19例并发面部血管瘤。4例病变累及双侧大脑半球,其余32例均为单侧发病。(1)CT表现为灰、白质分界不清的稍高密度灶者8例;病变脑叶内磨砂样及斑点状钙化者3例;病灶斑片状及线样钙化者8例,典型脑回样钙化者13例;上述32例病变区域均伴有不同程度脑萎缩。CT扫描未见明显异常者1例;CT增强扫描1例示病变区域脑表面软脑膜弥漫样强化。(2)MRI表现为病变区域不同程度脑萎缩,其中26例T2加权像(T2WI)表现为灰、白质分界不清的低或稍低信号(其中漏诊1例),3例T2WI表现为斑点状稍高信号。脉络丛扩大12例,14例可观察到颅板下、中线旁、患侧脑室旁的血管流空信号。3例增强扫描表现为沿皮层走行软脑膜弥漫样强化。(3)27例患儿同时予CT与MRI检查结果:CT结果阴性患儿MRI示T2WI表现为典型灰、白质分界不清的低或稍低信号;MRI漏诊患儿1例,CT上病变区表现为斑片状钙化。结论:CT和MRI检查对SWS诊断提供了重要的影像学诊断依据,都具有较为典型的影像学表现,CT与MRI联合应用可以相互补充,提供更多及更加准确的影像学信息,协助临床对SWS诊断;增强检查可明确诊断并确定病变范围。

Objective： To retrospectively analyze the CT and MRI imaging features of childhood Sturge-Weber syndrome（SWS） in 36 children aged 3 days to 11 years old. Methods： Images were collected from 36 cases of SWS, including 34 cases with CT scan alone and 29 cases with MRI alone, 27 cases with both CT and MRI, 1 case with contrast-enhanced CT and 3 cases with contrast-enhanced MRI. Results： Nineteen out of 36 cases had facial hemangioma. Involvement in unilateral brain was in 32 cases while involvement in bilateral cerebral hemispheres in 4 cases. ①Findings of CT scan included slightly increased density with an unclear boundaries of gray-white matter in 8 eases, ground glass appearance and spotty calcification in 3 eases, 8 cases with patchy and linear calcification, and 13 cases with typical gyriform calcifications, which all were accompanied by various extent of brain atrophy. One case appeared normal. Contrast-enhaneed CT scan showed 1 case with diffuse leptomeningeal enhancement. ②MRI features included various extent of brain atrophy in the lesional areas in all cases, reduced signal on T2WI with unclear boundaries of gray-white matter in 26 cases, slightly increased signal on T2WI in 3 eases, choroid plexus enlargement in 12 cases, vessel signal voids under the skull or beside midline or lateral ventricle in 14 cases. Contrast-enhanced MRI scan showed 3 cases with diffuse leptomeningeal enhancement. ③Twenty-seven patients were examined with both CT and MRI. One case with negative results on CT scan displayed reduced signal on T2WI with unclear boundaries of gray-white matter on MRI scan. One case with negative result on MRI showed patchy calcification within the lesion on CT scan. Conclusions： Comprehensive examination with CT and MRI can provide important imaging basis for the diagnosis of SWS. SWS exhibits typical imaging features in both CT and MRI, which both can compensate each other to provide more accurate imaging information. The enhanced scan is helpful for an accurate diagnosis and localization of lesions.