MRI Findings of Neurological Complications in Hand-Foot-Mouth Disease by Enterovirus 71 Infection
MRI Findings of Neurological Complications in Hand-Foot-Mouth Disease by Enterovirus 71 Infection
复制标题
DOI：
10.3109/00207454.2012.657379
复制
发表时间：
2012-07-01
影响因子：
2.2
通讯作者：
Wang, Ling
中科院分区：
文献类型：
--
作者：
Li, Jianjun;Chen, Feng;Wang, Ling
目的：探讨肠病毒71型（EV71）流行相关神经系统并发症的影像学特征。方法：收集海南省2008年5月~ 2010年9月EV71型手足口病伴神经系统并发症病例35例。所有患者均行MRI扫描。分析临床资料及MRI表现。结果：急性弛缓性麻痹伴EV71型手足口病7例。典型的MRI表现为脊髓后部的线性长T2信号强度。在t2加权横切面上可见脊髓内对称、界限分明的高强度病变。在对比增强的轴向t1加权图像中，可以看到明显增强的腹侧角和根。在21例脑桥炎中，延髓后部、中脑和脑桥可见长T1和长T2信号。7例无菌性脑膜炎（AM）的MRI表现为非特异性，但硬膜下积液、脑膜强化和脑积水可作为AM的间接征象。结论：MRI是研究EV71流行相关神经系统并发症的有效方法。延髓后部、脑桥和双侧脊髓前角受累是特征性表现。
Objective: To explore the imaging characterization of neurological complications associated with the enterovirus 71 (EV71) epidemics. Methods: Thirty-five cases of hand-foot-mouth disease with neurological complications during the recent EV71 outbreaks in Hainan Province, China, from May 2008 to September 2010 were collected. All patients were performed MRI scan. The clinical data and MRI appearance were analyzed. Results: Acute flaccid paralysis associated with EV71 infected hand-foot-mouth diseases was seen in seven cases. The typical MRI appearance was linear long T2 signal intensity in the posterior part of spinal cord. Symmetrical, well-defined hyperintensity lesions in the spinal cord were seen in T2-weighted transverse images. Obvious enhancements of the ventral horns and root were seen in the contrast-enhanced axial T1-weighted image. In 21 cases of pontine encephalitis, long T1 and long T2 signal intensity was seen in the posterior portions of the medulla oblongata, midbrain, and pons. It is nonspecific MRI appearance in seven cases of aseptic meningitis (AM), but subdural effusion, meningeal enhancement, and hydrocephalus can be indirect sign of AM. Conclusion: MRI is an effective modality to investigate neurological complications associated with the EV71 epidemics. Involvements of posterior portions of the medulla oblongata and pons, and bilateral anterior horns of spinal cord are characteristic findings.