摘要
目的:分析儿童Wernicke脑病的临床特点及MRI特征性表现。方法:回顾性分析2015年6月-2019年11月我院7例Wernicke脑病患儿的临床和MRI资料。结果:7例患儿均出现不同程度意识障碍,1例伴有眼肌麻痹,2例有共济失调。主要MRI为脑实质内多部位受累,病变部位包括丘脑内侧(7例)、中脑导水管周围灰质(6例)、第三脑室周围(4例)、四脑室底(4例)、尾状核和豆状核(2例)和乳头体(1例),病灶均对称性分布,T_(1)WI上呈等或低信号,T_(2)WI上呈高信号,T_(2)-FLAIR图像上呈高信号,DWI上5例可见高信号灶。所有患儿经维生素B1治疗3~10天后症状和体征逐渐好转,MRI显示颅内异常信号的范围减小或完全消失。结论:儿童Wernicke脑病的临床和MRI表现具有一定特征性,在及时诊断和治疗后神经系统症状可完全逆转。
Objective:The aim of this study was to analyze the clinical characteristics and MRI features of Wernicke encephalopathy in children.Methods:Clinical and MRI data of 7 children with Wernicke encephalopathy in our hospital from June 2014 to November 2018 were retrospectively analyzed.Results:All patients showed different degrees of unconsciousness.Ophthalmoplegia was found in one patient,and ataxia was found in two patients.MRI of 7 children showed multiple sites involvement.The locations of the lesions included medial thalami(n=7),periaqueductal gray matter(n=6),periventricular region of the third ventricle(n=4),the floor of the fourth ventricle(n=4),lentiform nucleus and caudate nucleus(n=2),and bilateral mammillary bodys(n=1).All lesions were symmetrically distributed,showed iso-or hypo-intensity on T_(1)WI,hyper-intensity on T_(2)WI and T_(2)-FLAIR images.Hyper-intensity lesions on DWI were found in 5 patients.Symptoms and signs improved gra-dually 3~10 days after treatment with vitamin B1,and MRI showed that the range of intracranial abnormal signal reduced or disappeared.Conclusion:Clinical and MRI findings of Wernicke encephalopathy in children have certain characteristics.The neurological symptoms of the patients can be completely reversed after timely diagnosis and treatment.
作者
张琦
鹿松
王丽华
宋修峰
ZHANG Qi;LU Song;WANG Li-hua(Department of Radiology,the Qingdao University Women and Children's Hospital,Shandon 266034,China)
出处
《放射学实践》
CSCD
北大核心
2021年第8期1048-1051,共4页
Radiologic Practice