磁共振3D-ASL定量评估儿童病毒性脑炎脑灌注特征

目的:探讨儿童病毒性脑炎的磁共振三维动脉自旋标记（3D-ASL）成像的灌注特征。方法:回顾性收集25例急性病毒性脑炎患儿和25名年龄相仿的健康对照组。在脑血流量（CBF）伪彩图上对每个患者进行视觉评估,定量分析病变区与对照组CBF值差异,确定儿童病毒性脑炎的脑灌注特征。结果:25例病毒性脑炎患儿在急性期灌注显著增高,急性病变的CBF值、标准化CBF值显著高于对照组,其ROC-AUC值分别为0.971和0.992。9例患儿在治疗好转后进行复查,病变区血流灌注随病情好转而减低。结论:儿童病毒性脑炎的3D-ASL成像表现有一定特征,病灶在急性期灌注显著增高,病情好转后减低。3D-ASL可以为儿童病毒性脑炎诊断和随访提供一种新的影像学参考。

Magnetic resonance 3D-ASL for quantitative assessment of cerebral perfusion characteristics in children with viral encephalitis

Abstract: Objective To investigate the cerebral perfusion characteristics in children with viral encephalitis using magnetic resonance 3D arterial spin labeling (3D-ASL) imaging. Methods Twenty-five pediatric patients with acute viral encephalitis and 25 age-matched healthy controls were enrolled retrospectively. Each patient was evaluated visually on a pseudo-color map of cerebral blood flow (CBF), and the difference between CBF value of the lesion area and that of control group was analyzed quantitatively for determining the cerebral perfusion characteristics of children with viral encephalitis. Results The perfusions in 25 pediatric patients with viral encephalitis were significantly increased in the acute phase. The CBF and normalized CBF values of the acute lesions were significantly higher than those of control group, and their ROC-AUC values were 0.971 and 0.992, respectively. Nine pediatric patients were re-examined after effective treatment, and it was found that the blood perfusion in the lesion area was decreased with the condition improvement of the disease. Conclusion Viral encephalitis in children has certain characteristic imaging manifestations on 3D-ASL. The lesions demonstrate hyperperfusion in the acute phase, and the perfusion is decreased after patients condition is improving. 3D-ASL can provide a new imaging reference for the diagnosis and follow-up of children with viral encephalitis.