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

发布时间：2018-04-19 22:03

本文选题：免疫正常 + 儿童　；参考：《中国介入影像与治疗学》2016年06期

【摘要】：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
[Abstract]:Objective to investigate the MRI features and vascular changes of primary cryptococcal meningoencephalitis (CMM) in children. Methods the clinical data of 17 cases of immune normal children with CM were analyzed retrospectively. All the children received plain scan of cranial MRI in 9 cases and contrast-enhanced scan in 13 cases, of which 7 cases received enhanced MRA and MRV. Results all the 17 children were positive on Mr examination. The main manifestations were dilatation of ventricular system with bilateral paraventricular edema in 5 cases, widening of perivascular space in 12 cases, gelatinous pseudocyst in 7 cases and edema of cerebral parenchyma in 10 cases. Of the 9 children with basal ganglia calcification, 7 cases had abnormal intracranial enhancement. 6 cases were found abnormal by MRA, which were mainly the thinning of main artery, stenosis or decrease of branches. 13 cases were found to have abnormal venous sinus by MRV, mainly transverse sinus and / or sigmoid sinus became thin, interrupted or disappeared, internal jugular vein or straight sinus disappeared. Conclusion cranial Mr examination can accurately reflect the pathological features of CM, which is beneficial to early diagnosis and timely treatment of CM. It is also helpful to early diagnosis and timely treatment of CM.
【作者单位】：首都医科大学附属北京儿童医院影像中心;首都医科大学附属北京儿童医院感染内科;
【基金】：国家自然科学基金面上项目(31271161) 北京市属医院科研培育计划(PX2016035) 北京市高层次卫生技术人才培养计划(2015-3-082)
【分类号】：R725.1;R445.2

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