颅脑MRI不同序列对小儿手足口病并发脑炎的诊断价值

目的：探讨颅脑MRI不同序列对小儿手足口病并发脑炎不同时期的诊断价值及其成像的病理基础。方法：对100例小儿手足口病出现脑炎早期临床表现的患儿行轴位常规序列（T2WI、T1WI）和T2FLAIR、DWI序列扫描，其中56例有MRI阳性表现，56例中30例首次MRI检查后分别于第2周（13例）、第3周（17例）行MRI复查，扫描序列同上。比较4种成像序列对小儿手足口病并发脑炎不同时期病变的检出率。结果：56例患儿显示病灶共147个，病灶多为对称性，MRI主要表现为T1WI稍低信号或低信号，T2WI、T2FLAIR、DWI呈稍高信号或高信号的片状、斑点状影，边缘模糊，部分病灶于T2FLAIR或DWI序列上显示更清楚。T1WI显示病灶50个（50/147），T2WI显示病灶65个（65/147），T2FLAIR显示病灶120个（120/147），DWI显示病灶109个（109/147）。DWI和T2FLAIR分别与T2WI、T1WI相比，P＜0.05；T2FLAIR与DWI、T1WI与T2WI相比，P＞0.05。30例复查病例显示病灶共73个，T1WI显示病灶55个（55/73），T2WI显示病灶57个（57/73），T2FLAIR显示病灶68个（68/73），DWI显示病灶15个（15/73）。T2FLAIR与DWI相比，P＜0.05；DWI分别与T1WI、T2WI相比，P＜0.05；T2WI与T2FLAIR、T1WI与T2WI相比，P＞0.05。结论：T2FLAIR、DWI序列相结合对小儿手足口病并发脑炎早期诊断有重要临床价值，T2FLAIR对小儿手足口病并发脑炎恢复期诊断有重要临床价值；T2FLAIR、DWI可作为小儿手足口病并发脑炎早期检查的首选序列。

The value of different MR sequences in the diagnosis of hand-foot-mouth disease complicated with encephalitis

Abstracd： Objective： To investigate MRI with different sequences in the diagnosis of encephalitis in hand-foot-mouth disease, and correlated with pathology. Methods： In 100 children with hand-foot-mouth disease who had early clinical manifestations of encephalitis underwent axial routine T2WI, T1WI, T2FLAIR, DWI sequences, 56 cases had MRI positive expression, in the 56 cases, 30 cases in the first MRI scan, 13 cases had a second repeat MR examination on the second week（13/ 30）, 17 cases （17/30） had a repeat MR examination on the third week, scanning sequence the same as above. The detection rate was compared between 4 imaging sequences in different periods of disease. Results： In 56 cases there were 147 lesions, the lesion was symmetrical on both sides, MRI showed slightly low signal/low signal on TiWI, and on T2WI, T2FLAIR, DWI showed slightly high signal/high signal mottled shadow, blurred edges, some lesions on T2FLAIR or DWI sequence showed more clearly. T1WI showed 50（50/147）, T2WI showed 65（65/147）, T2FLAIR showed 120（120/147）, DWI showed 109（109/147）. DWI and T2FLAIR compared With T2WI, T1WI （P〈0.05）, T2FLAIR compared with DWI, T1WI compared with T2WI （P〉0.05）. Thirty cases on repeat MR examination showed the 73 lesions. T1WI showed 55 （55/73）, T2WI showed 57 （57/73）, T2FLAIR showed 68 （68/73）, DWI showed 15 （15/73）. T2FLAIR compared with DWI （P〈0.05）, DWI compared with T,WI, T2WI （P〈0.05）, T2WI compared with T2FLAIR, T1WI compared with T2WI （P〉0.05）. Conclusion： The combination of T2FLAIR, DWI sequence has important clinical value early diagnosis in for children with hand-foot-mouth disease complicated with encephalitis, T2FLAIR has important clinical value in the diagnosis of children with hand-foot-mouth disease complicated with encephalitis recovery. T2FLAIR, DWI can be used as the preferred sequence for hand-foot-mouth disease complicated with encephalitis. Key words： Hand, foot and mouth disease; Encephalitis; Magnetic rasonance imaging