MRI characteristics of brainstem encephalitis in hand-foot-mouth disease induced by enterovirus type 71-Will different MRI manifestations be helpful for prognosis?
MRI characteristics of brainstem encephalitis in hand-foot-mouth disease induced by enterovirus type 71-Will different MRI manifestations be helpful for prognosis?
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DOI：
10.1016/j.ejpn.2013.03.004
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发表时间：
2013-09-01
影响因子：
3.1
通讯作者：
Li, Yan
中科院分区：
文献类型：
--
作者：
Chen, Feng;Li, Jianjun;Li, Yan
本文对21例EV71型感染的手足口病合并脑干脑炎患者的MRI特征进行了检查，以确定病变模式，有助于疾病分类和预后。作者回顾了2008年5月至2010年9月中国海南EV71暴发期间感染的21例脑干脑炎患儿的临床和MRI资料。脑干脑炎13例，根据单侧或双侧对称片状高信号局限于脑干后部的T-1和T-2归类为I型。在这些病例中的少数（6/13）中，还发现了脊柱前角的损伤。13例I型患者中，2例死亡，7例完全康复，4例出现各种神经系统后遗症。8例脑干后腔T1、T2信号模糊、斑点状高信号，诊断为ⅱ型脑干脑炎。6例完全康复，2例有轻度后遗症。MRI复查显示，只有1例II型病例出现持久病变，局限于延髓。ⅱ型患者预后好于ⅰ型患者。MRI显示的病变模式可以区分EV71感染引起的I型和II型脑干脑炎，并可能对预后有价值。在两组患者中，病变通常位于脑干的基底部分，而I型病例也表现为脊髓、丘脑和皮层病变。(C) 2013年欧洲儿科神经病学学会。Elsevier Ltd.出版。版权所有。
The MRI characteristics of 21 HFMD patients with brainstem encephalitis resulting from EV71 infection were examined to identify lesion patterns helpful in disease classification and prognosis. The author reviewed the clinical and MRI data of 21 children with brainstem encephalitis infected during the EV71 outbreak in Hainan, China from May 2008 to September 2010. Thirteen cases of brainstem encephalitis were classified as type I based on unilateral or bilateral symmetrical patch-like hyperintense T-1 and T-2 MRI signals restricted to the posterior brainstem. In a significant minority of these cases (6/13), damage to the spinal ventral horn was also found. Among these 13 type I cases, 2 patients died, 7 recovered fully, and 4 suffered from various neurological sequelae. Eight cases were classified with type II brainstem encephalitis based on a vague, speckled hyperintense T1 and T2 signal pattern in the posterior brainstem. Six of these patients recovered fully, and 2 cases suffered from mild sequelae. Reexamination by MRI revealed an enduring lesion in only one type II case, restricted to the medulla oblongata. The prognosis of type II cases was better than that of type I cases. The lesion pattern revealed by MRI can distinguish type I from type II brainstem encephalitis due to EV71 infection and may prove valuable for prognosis. While lesions were usually located in the tegrnental part of the brainstem in both patient groups, type I cases also demonstrated spinal, thalamic, and cortical lesions. (C) 2013 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.