MRI characteristics and pathogenesis of brainstem encephalitis in the enterovirus type 71 infected hand-foot-mouth disease

CHEN Feng1; LI Jian-jun1; LIU Tao2; WEN Guo-qiang2; XIANG Wei3

doi:10.13406/j.cnki.cyxb.2011.09.010

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MRI characteristics and pathogenesis of brainstem encephalitis in the enterovirus type 71 infected hand-foot-mouth disease

更新时间：2024-01-17

- MRI characteristics and pathogenesis of brainstem encephalitis in the enterovirus type 71 infected hand-foot-mouth disease
- Journal of Chongqing Medical University Vol. 36, Issue 9, Pages: 1097-1100(2011)
- 作者机构：
  
  1. 海南省人民医院放射科
  2. 海南省人民医院神经内科
  3. 海南省人民医院儿科
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.2011.09.010
  CLC： R445.2
- Published：2011，
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[1]陈峰,李建军,刘涛,文国强,向伟.肠道病毒71型感染手足口病合并脑干脑炎MRI特点及机制探讨[J].重庆医科大学学报,2011,36(09):1097-1100.

CHEN Feng1, LI Jian-jun1, LIU Tao2, et al. MRI characteristics and pathogenesis of brainstem encephalitis in the enterovirus type 71 infected hand-foot-mouth disease. [J]. Journal of Chongqing Medical University 36(9):1097-1100(2011)
[1]陈峰,李建军,刘涛,文国强,向伟.肠道病毒71型感染手足口病合并脑干脑炎MRI特点及机制探讨[J].重庆医科大学学报,2011,36(09):1097-1100. DOI： 10.13406/j.cnki.cyxb.2011.09.010.

CHEN Feng1, LI Jian-jun1, LIU Tao2, et al. MRI characteristics and pathogenesis of brainstem encephalitis in the enterovirus type 71 infected hand-foot-mouth disease. [J]. Journal of Chongqing Medical University 36(9):1097-1100(2011) DOI： 10.13406/j.cnki.cyxb.2011.09.010.

摘要

目的:探讨肠道病毒71型（Enterovirus type 71

EV71）感染合并脑干脑炎的磁共振（Magnetic resonance imaging

MRI）特点

并根据MRI特点进行分型

分析分型与预后的关系

并探讨脑干脑炎的发病机制。方法:回顾性分析2008年5月至2010年9月中国海南EV71感染流行期间21例伴有脑干脑炎手足口病（Hand-foot-mouth disease

HFMD）患儿临床、MRI表现

并随访3个月至2年不等。结果:根据MRI特征将脑干脑炎归类为Ⅰ型13例

表现为脑干后部局限性单侧或双侧对称性斑点状长T1长T2信号

部分合并脊髓前角的损害

随访发现2例死亡

7例完全康复

4例遗留不同程度的神经系统后遗症

复查MRI发现2例遗留延髓及桥脑病灶;脑干脑炎Ⅱ型8例

表现为脑干后部模糊的片状稍长T1稍长T2信号

随访发现6例完全康复

2例遗留轻度后遗症;复查MRI发现仅1例遗留延髓病灶。脑干脑炎Ⅱ型预后好于Ⅰ型。结论:MRI是评价EV71型感染手足口病合并脑干脑炎的有效方法

损害部位常位于脑干被盖部

影像表现具有相对特异性;以影像学表现进行的分型有助于对预后的判断。

Abstract

Objective:To explore the magnetic resonance imaging(MRI) characteristics and classification of brainstem encephalitis combined with the enterovirus type 71(EV71) epidemic by analyzing 21 patients

and to identify the prognoses and explore the pathogenesis of brainstem encephalitis.Methods:21 cases of hand-foot-mouth disease(HFMD) with brainstem encephalitis during the recent EV71 outbreaks in Hainan Province

China from May 2008 to September 2010 were described

and literatures were reviewed.The recovery of their impairment was followed up for 3 months to 2 years.Results:According to the MRI features

brainstem encephalitis was classified into 2 types.In brainstem encephalitis Type Ⅰ(13 cases)

all lesions were presented as local

spotty and significantly hyperintense in the brainstem as seen in T2WI and hypointense in T1WI.Of the 13 cases

2 died

7 recovered

and 4 got improved with sequela.Lesions in medulla oblongata and pons were found in 2 cases in follow up.Brainstem encephalitis Type Ⅱ(8 cases) appeared to be blurred and slightly hyperintense in T2WI and hypointense in T1WI in the posterior portions of the brainstem.Of the 8 cases

6 recovered

and 2 got improved with sequela.Patients with brainstem encephalitis Type Ⅰ had a worse prognosis than those with Type Ⅱ.Conclusion:MRI is an effective method to investigate brainstem encephalitis combined with the enterovirus 71 epidemic.Posterior portions of the brainstem involvement are characteristic findings of enteroviral encephalomyelitis.The MRI based classification may be helpful in making a better estimation of prognosis.

关键词

脑干脑炎手足口病肠道病毒感染磁共振成像

Keywords

brainstem encephalitishand-foot-mouth diseaseenterovirus infectionmagnetic resonance imaging

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