PICU重症病毒性脑炎儿童CT、MRI影像学特征分析

Analysis on CT and MRI Features of Children with Severe Viral Encephalitis in PICU

目的探讨重症监护病房(PICU)重症病毒性脑炎儿童CT、MRI影像学特征。方法选取2017年1月至2018年7月我院PICU收治的重症病毒性脑炎儿童60例为研究对象,均采用CT、MRI两种影像学方式进行检查,比较两种方式的检查结果,分析临床应用价值。结果 60例患者中有48例被确诊为病毒性脑炎,5例被误诊为其他疾病,7例因影像显示无异常漏诊,阳性检出率为80.00%;48例患儿中18例在额叶处,6例在颞叶处,18例病灶在基底节,6例在脑顶叶处MRI检查确诊为病毒性脑炎的有56例,其中漏诊3例,误诊1例,阳性检出率为93.33%;脑内异常病灶在基底节的有22例,5例在颞叶处,15例在额叶处,4例在枕叶处,7例在脑顶叶处,以及小脑和丘脑处各有1例,其中2例为多发患者。结论 CT、MRI检查在病毒性脑炎患儿中均具有一定的诊断价值,但MRI检查对病毒性脑炎的诊断误诊、漏诊率明显低于CT检查,具有更高的临床应用价值,值得在临床上推广。

Objective To explore CT and MRI features of children with severe viral encephalitis in pediatric intensive care unit(PICU). Methods A total of 60 children with severe viral encephalitis who were admitted to PICU of the school from January 2017 to July 2018 were enrolled as study objects. All of them were examined by CT and MRI. The examination results of the two methods were compared. Clinical application value was analyzed. Results Of the 60 patients, there were 48 cases confirmed with viral encephalitis, 5 cases misdiagnosed with other diseases, 7 cases with missed diagnosis caused by imaging showing no anomaly. The positive detection rate was 80.00%. Of 48 patients, there were 18 cases at frontal lobe, 6 cases at temporal lobe, 18 cases with lesions at basal ganglia, and 6 cases at parietal lobe. There were 56 cases confirmed with viral encephalitis by MRI, including 3 cases with missed diagnosis and 1 case misdiagnosed. The positive detection rate was 93.33%. There were 22 cases with brain abnormal lesions at basal ganglia, 5 cases at temporal lobe, 15 cases at frontal lobe, 4 cases at occipital lobe, 7 cases at parietal lobe, 1 case at cerebellum and 1 case at thalamus. 2 cases of which were multiple patients. Conclusion Both CT and MRI are of certain diagnostic value for children with viral encephalitis. However, misdiagnosis and missed diagnosis rates of MRI for viral encephalitis are significantly lower than those of of CT, which is of higher clinical application value, and worthy of clinical promotion.