摘要
目的研究磁共振弥散加权成像(DWI)在病毒性脑炎患儿中的诊断价值及与阶段分期关系。方法对中国医科大学附属盛京医院小儿神经内科2006年6月至2007年2月临床确诊的病毒性脑炎56例患儿进行传统磁共振成像(MRI)和DWI检查,异常者29例,其中13例做了2次头MRI。共42例次存在不同程度头MRI异常。依据患儿MRI传统序列与DWI的差别将其分为3组,对每组患儿患侧病灶表观弥散系数(ADC)与对侧正常脑组织进行比较。结果Ⅰ组DWI显示的病灶数目和病灶范围均优于MRI;Ⅱ组DWI与MRI相近;Ⅲ组MRI优于DWI。3组患儿病灶与对侧正常脑组织ADC值平均值分别是:Ⅰ组病灶(0.45±0.19)×10-3mm2/s,正常(0.93±0.06)×10-3mm2/s;Ⅱ组病灶(0.87±0.31)×10-3mm2/s,正常(0.97±0.06)×10-3mm2/s;Ⅲ组病灶(1.66±0.60)×10-3mm2/s,正常(1.08±0.24)×10-3mm2/s。Ⅰ组患儿ADC值较Ⅱ组明显降低,Ⅲ组患儿ADC值最高(P<0.05)。结论 DWI显示早期脑炎患儿的病灶范围和数目方面优于MRI,DWI结合MRI,能判断病程阶段。
Objective The aim of this study was to evaluate the role of diffusion-weighted imaging （DWI） in the diagnosis of viral encephalitis and its relationship with the stage of the illness. Methods We performed conventional magnetic resonance imaging （MRI） including TIWI, T2WI sequences and DWI in 56 patients with viral encephalitis diagnosed on the basis of laboratory, clinical and radiologic findings, in which 29 patients were abnormal. Thirteen patients have received MRI two times. So , there were 42 case-times of abnormal MRI.Based on the qualitative and quantitative comparison of the conventional MRI and DWI, the patients were divided into three groups. Apparent diffusion coefficient （ADC） values of the involved and contralateral normal brain tissues were computed and compared for each group. Results In group Ⅰ（n = 23） DWI was superior to conventional MRI in detecting the encephalitic involved sites and in depicting the borders of the encephalitic lesions. In group II （n = 11） DWI was similar to conventional MRI. In group Ⅲ （n = 8） conventional MRI was superior to DWI. Mean ADC values of affected versus contralateral normal brain tissues were 0.45± 0.19×10^-3mm2/sVS 0.93 ±0.06×10^-3mmZ/s in group Ⅰ ,0.87 ± 0.31 ×10^-3 mm2/s VS 0.97 ＋ 0.06 ×10^-3 mm2/s in group Ⅱ , and 1.66± 0.60 ×10^-3mm2/s VS 1.08± 0.24 ×10^-3mm2/s in group m. Patients in group I had significantly lower ADC values than those in groupⅡ , while patients in group Ⅲ had the highest ADC values （P 〈 0.05）. The ADC values were significantly lower in the affected sites than in the unaffected sites of patients in groups Ⅰ and Ⅲ , but were significantly higher in the affected sites than in the unaffected sites of patients in group Ⅲ （P 〈 0.05）. There was an excellent correlation between ADC values and duration of the disease （r = 0.874, P = 0.01 ）. Conclusion DWI is superior to other conventional diagnostic MR sequences in the detection of early viral encephalitic lesions and depiction of the lesion borders and, in combination with other sequences, DWI may contribute to the determination of the disease phase.
出处
《中国实用儿科杂志》
CSCD
北大核心
2010年第10期794-797,共4页
Chinese Journal of Practical Pediatrics
关键词
磁共振
弥散加权成像
病毒性脑炎
表观弥散系数
magnetic resonance imaging
diffu-sion-weighted imaging
viral encephalitis
apparent diffusion coefficient
