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婴幼儿脑皮质层状坏死的磁共振影像特点 被引量:2

The MRI Diagnosis of Infant Cerebral Cortical Laminar Necrosis
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摘要 目的总结分析婴幼儿脑皮质层状坏死的磁共振图像特点,提高对此征象的认识。方法回顾性分析2012年5月-2016年1月经MR检查发现脑皮质层状坏死的29例婴幼儿患者MR图像,总结CLN的MR影像特点及后遗改变。结果 29例患儿中,化脓性脑膜脑炎8例,急性脑梗7例,病毒性脑炎5例,脑外伤5例,缺血缺氧性脑病并低血糖脑病4例。MR于发病之日起平均19.3天发现CLN,呈脑回样T1WI及FLAIR高信号。19例患儿急性期DWI示病变部位皮层高信号,T1WI及FLAIR序列无高信号,复查MR示原DWI高信号部位出现脑回样T1WI高信号,且范围与DWI一致,此时DWI高信号范围较T1WI小。19例患儿随访1-28月,病变多数持续存在(16/19),且CLN部位出现脑软化和(或)脑萎缩。结论婴幼儿CLN多见于化脓性脑膜脑炎、病毒性脑炎、急性脑梗、脑外伤、缺血缺氧性脑病及低血糖脑病患儿,MR图像有特征性改变,DWI可早期预测CLN部位及范围,CLN可持续存在2年左右,并可导致病变部位遗留脑软化和(或)脑萎缩。 Objective To investigate the MR imaging features of infant cerebral cortical laminar necrosis.Methods We retrospectively analyzed the MR images of 29 infant CLN patients,who were examined in our MR department from May 2012 to January 2016.We studied the MR imaging characteristics and after-effect signs.Results 8 cases were diagnosed suppurative meningitis,7 cases were diagnosed ACI,5 cases were diagnosed viral encephalitis,5 cases were diagnosed cerebral trauma,4 cases were diagnosed HIE and hypoglycemic encephalopathy.CLN could be found in 19.3 days after the illnesses attack.CLN appeared gyriform high signal in T1WI and FLAIR.At the acute phase,the CLN range in T1WI was same with in DWI.In DWI,The cortex lesions appeared diffusionlimited at the acute phase,there were no high signals in the T1WI or FLAIR.At this moment,the range of high signals in DWI less than in T1WI.19 cases were followedup 1-28 months,the CLN were existed and accompanied with encephalomalacia and/or encephalatrophy.Conclusion The CLN of infant was mostly happened to suppurative meningitis,ACI,viral encephalitis,cerebral trauma,HIE and hypoglycemic encephalopathy.Typical imaging features of CLN is gyriform high signal in T1WI and FLAIR.DWI could early forecast the position and the range of CLN.The CLN could existed in almost 2 years.The prognosis is not good.
作者 杨洁 关晓力 毕璐琳 YANG Jie;GUAN Xiao-li;BI Lu-lin(Department of MR Room,Taiyuan 030013,Shannxi Province,China;Children's Hospital of Shannxi,Taiyuan 030013,Shannxi Province,China)
出处 《中国CT和MRI杂志》 2018年第1期5-7,共3页 Chinese Journal of CT and MRI
关键词 脑疾病 磁共振成像 脑皮质层状坏死 弥散加权成像 Brain Diseases Magnetic Resonance Imaging Cortical Laminar Necrosis Diffusion-weighted Imaging
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