免疫正常儿童原发隐球菌脑膜脑炎的MRI表现及血管改变特点

目的探讨儿童原发隐球菌脑膜脑炎(CM)的MRI表现及血管改变特点。方法回顾性分析17例临床证实为CM的免疫正常患儿资料。所有患儿均接受头颅MR平扫;9例接受增强扫描;13例接受头颅MRA和MRV,其中7例为增强后MRA和MRV。结果 17例患儿MR检查均为阳性。平扫主要表现为脑室系统扩张伴有双侧脑室旁水肿5例,脑实质内血管周围间隙增宽12例,脑实质内出现胶状假囊7例,脑实质内水肿10例,基底节钙化1例。9例接受增强扫描的患儿中,7例颅内可见异常强化灶。13例经MRA检查发现6例异常,主要为动脉主干的变细、狭窄或分支减少;且13例均经MRV检查发现静脉窦异常,主要为横窦和(或)乙状窦变细、中断或消失,颈内静脉或直窦消失。结论头颅MR检查可较为准确地反映CM的病理学特征,有利于临床早期诊断并及时治疗MR检查可较为准确地反映CM的病理学特征,有利于临床早期诊断并及时治疗

MRI characters and vessel changes of immunocompetent children with primary cryptococcus meningoencephalitis

Objective To evaluate MR imaging characters and vessel changes of immunocompetent children with primary cryptococcus meningoencephalitis (CM). Methods Data of 17 CM childen with normal immunocompetent confirmed by laboratory examinations were retrospectively analyzed. All the cases underwent MR plain scan, while 9 of them underwent contrast-enhanced MRI (CE-MRI), and 13 of them underwent both of MRA and MRV including 7 cases of contrast-enhanced scan and another 6 cases of plain scan. Results Abnormal manifestations were found in all of 17 cases on MR imagies. The manifestations of MR plan scan included hydrocephalus with cerebral edema around lateral ventricle cerebral in 5 cases, dilatation of Virchow-Robin spaces in 12 cases, gelatinous pseudocysts in 7 cases, multiple patchy edema of brain parenchyma in 10 cases, symmetrical patchy calcification of bilateral basal ganglia in 1 case. Intracranial abnormal enhancement was found in 7 of 9 cases who underwent CE-MRI scan. Among 13 cases, totally 6 cases with abnormal signs were detected by MRA, and the manifestations including main artery becoming thin, narrow or branches reduction. The abnormal signs included transverse sinus and (or) sigmoid sinus stenosis or disappearance, and internal jugular vein and straight sinus disappearance were found by MRV in all of 13 cases. Conclusion Brain MR examinations may influence the pathological characters of CM more precisely, which is helpful for early diagnosing and timely treatment in clinic.