儿童肺吸虫脑病25例临床与影像学特征

发布时间：2018-01-31 01:48

本文关键词： 肺吸虫磁共振成像儿童脑出血　出处：《中国实用儿科杂志》2015年07期 　论文类型：期刊论文

【摘要】：目的探讨儿童肺吸虫脑病临床表现和磁共振成像(MRI)特点。方法收集2012年6月至2014年10月遵义医学院附属医院临床确诊的肺吸虫脑病患儿25例,年龄6~14岁,回顾性分析其临床资料和MRI影像学表现。结果 25例中18例有明确生食溪蟹、淡水虾史。临床表现:头痛23例,癫痫11例,发热9例;25例外周血嗜酸性粒细胞绝对数及百分比均升高,肺吸虫血清抗体均阳性。MRI特征:24例病灶位于大脑皮质和皮质下区,1例位于丘脑,累及顶叶14例、颞叶10例、枕叶8例、额叶6例。脑实质出血16例,多表现为皮质及皮质下单一血肿团;脑炎型9例,表现为大片水肿和环形、结节样强化,其中"隧道征"3例。合并胸部肺吸虫病10例。结论儿童肺吸虫脑病临床表现复杂,MRI表现具有特征性,诊断应结合影像学、血嗜酸性粒细胞计数及免疫学检查做到早诊断、早治疗。
[Abstract]:Objective to investigate the clinical manifestations and magnetic resonance imaging (MRI) of paragonimiasis in children. Methods from June 2012 to October 2014, 25 children with paragonimiasis were collected from affiliated Hospital of Zunyi Medical College. The clinical data and MRI imaging findings were retrospectively analyzed. Results 18 of 25 cases had clear history of raw crabs and freshwater shrimp. Clinical manifestations: headache 23 cases epilepsy 11 cases. Fever in 9 cases; The absolute number and percentage of eosinophilic granulocytes in peripheral blood were all increased in 25 cases, and the serum antibodies of paragonimiasis were all positive. MRI features showed that 24 lesions were located in cerebral cortex and subcortical area in 1 case in thalamus. The parietal lobe was involved in 14 cases, temporal lobe in 10 cases, occipital lobe in 8 cases, frontal lobe in 6 cases. 9 cases of encephalitis type showed large edema and ring, nodular enhancement, including 3 cases of "tunnel sign" and 10 cases of thoracic paragonimiasis. Conclusion the clinical manifestations of children with paragonimiasis are complicated. MRI features are characteristic, diagnosis should be combined with imaging, blood eosinophil count and immunological examination to make early diagnosis and early treatment.
【作者单位】：遵义医学院附属医院影像科;
【分类号】：R725.3;R445.2
【正文快照】： 并殖吸虫主要在人体肺脏寄生,临床常称肺吸虫,在我国东北、华中、华南、西南等23个省、自治区广泛分布,卫氏和斯氏并殖吸虫是我国主要致病虫种,发病率南方明显高于北方。肺吸虫病多见于儿童及青少年,因生食或半生食肺吸虫第二宿主溪蟹、噐蛄而感染[1],脑型肺吸虫(paragoni-mia

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