重症手足口病合并脑脊髓炎的MRI特征及临床意义

目的探讨MRI对重症手足口病合并脑脊髓炎的诊断价值及临床意义。方法选择广东省东莞市虎门镇虎门大道太平人民医院2010年1月～2012年6月收治入院的25例经临床诊断为重症手足口病合并脑脊髓炎患儿的头颅及脊髓MRI检查资料进行回顾性分析。结果 15例T1WI呈低信号,T2WI呈高信号,边界清晰,FLAIR、DWI呈等或低信号,无强化;10例T1WI呈稍低信号,T2WI呈稍高信号,边界模糊,FLAIR、DWI正常或呈高信号,其中5例表现为斑片状强化;2例脊髓炎病例均呈纵行长条状T2WI高信号影,T1WI呈低信号,边缘清晰;横断位病灶呈对称性类圆形,位于脊髓前角,脊髓无增粗。结论重症手足口病并脑干脑炎MRI与临床表现具有一定关系,MRI检查可以显示脑部及脊髓病变的部位、范围和严重程度,为临床诊断、治疗及预后提供可靠的影像学依据。

MRI characteristics and clinical significance of severe hand,foot and mouth disease and encephalomyelitis

Objective To evaluate the diagnostic value and clinical significance of MRI for severe hand,foot and mouth disease and encephalomyelitis.Methods The head and spinal MRI findings of 25 children dignosed with severe hand,foot and mouth disease combined encephalomyelitis in Humen Avenue Taiping People＇s Hospital of Humen Town in Dongguan City,Guangdong Province,from January 2010 to June 2012 were retrospectively analyzed.Results 15 cases of patients were found with low signal on T 1 WI,high signal on T 2 WI,the boundaries was clear,FLAIR,DWI showed equisignal or low signal,and there was no enhancement;10 cases of patients were found with slightly low signal on T 1 WI,slightly higher signal on T 2 WI,the boundaries was fuzzy,FLAIR,DWI showed high signal,of which 5 cases showed patchy strengthen.2 cases of myelitis cases were found with vertical strip high signal on T2WI,low signal on T1WI,the boundaries was clear;transverse lesions showed symmetry class round in anterior horn of the spinal cord without spinal cord thickening.Conclusion The MRI findings of severe hand,foot and mouth disease combined encephalomyelitis has a certain relationship with clinical manifestations,MRI examination can show the location,extent and severity of the brain and spinal cord lesions,and provide reliable imaging evidence for clinical diagnosis, treatment and prognosis.