發(fā)布時(shí)間：2018-03-29 02:20

  本文選題：磁共振　切入點(diǎn)：腦膜　出處：《中華醫(yī)院感染學(xué)雜志》2017年10期

【摘要】：目的探討磁共振腦膜強(qiáng)化模式在嬰幼兒顱內(nèi)感染診斷中的應(yīng)用價(jià)值,為臨床診治提供參考依據(jù)。方法選取2013年7月-2014年6月醫(yī)院收治的76例經(jīng)腦脊液檢查確診的顱內(nèi)感染嬰幼兒,所有患兒均經(jīng)T1WI增強(qiáng)掃描以及磁共振常規(guī)平掃,腦膜強(qiáng)化共有4級(jí),觀察分析所有嬰幼兒磁共振腦膜強(qiáng)化的影像學(xué)表現(xiàn)。結(jié)果磁共振檢查中,12例(15.79%)化膿性腦膜炎有10例(83.33%)表現(xiàn)為全腦膜強(qiáng)化;28例(36.84%)例病毒性腦膜炎中有8例(28.57%)表現(xiàn)為軟腦膜可疑過度強(qiáng)化,9例(32.14%)表現(xiàn)為蛛網(wǎng)膜-軟腦膜強(qiáng)化,5例(17.86%)表現(xiàn)為全腦膜強(qiáng)化級(jí);21例(27.63%)結(jié)核性腦膜炎有13例(61.90%)表現(xiàn)為腦基底池異常強(qiáng)化;15例(19.74%)其他感染中4例(26.67%)表現(xiàn)為腦基底池異常強(qiáng)化,1例(6.67%)表現(xiàn)為軟腦膜可疑過度強(qiáng)化,2例(13.33%)表現(xiàn)為蛛網(wǎng)膜-軟腦膜強(qiáng)化;增強(qiáng)后12例化膿性腦膜炎,10例(83.33%)為Ⅰ級(jí),2例(16.67%)為Ⅲ級(jí);28例病毒性腦膜炎中14例(50.00%)為0級(jí),9例(32.14%)Ⅱ級(jí),5例(17.86%)Ⅲ級(jí);21例結(jié)核性腦膜炎中7例(33.33%)為0級(jí),1例(4.76%)Ⅱ級(jí),13例(61.90%)Ⅲ級(jí);15例其他感染中8例(53.33%)0級(jí),1例(6.67%)Ⅰ級(jí),6例(40.00%)為Ⅱ級(jí)。結(jié)論嬰幼兒具有較為豐富的軟腦膜表面毛細(xì)血管,僅僅依靠軟腦膜輕中度強(qiáng)化,難以作為顱內(nèi)感染的可靠征象,再加之嬰幼兒顱內(nèi)感染早期病理變化較為輕微,因此在確診中需要和臨床診斷相互結(jié)合。
[Abstract]:Objective to evaluate the value of magnetic resonance meningeal enhancement model in the diagnosis of infantile intracranial infection. Methods from July 2013 to June 2014, 76 infants with intracranial infection diagnosed by cerebrospinal fluid examination were selected. All of them underwent T1WI enhanced scanning and conventional plain MRI. Meningeal enhancement has four levels. Results in Mr examination, 12 cases (15.79%) and 10 cases of suppurative meningitis (83.33%) showed total meningeal enhancement in 28 cases (36.84 cases) and viral meningitis in 8 cases (28.57%). Suspected excessive enhancement of pia meninges 9 cases (32.14): arachnoid / pial meningeal enhancement (5 cases / 17.86): total meningeal enhancement grade (21 cases)) tuberculous meningitis (13 cases (61.90)): abnormal enhancement of basal cistern (15 cases) and other infections (4 cases). The abnormal enhancement of basal cistern was found in 1 case (6. 67) and suspected excessive enhancement of pia meninges in 2 cases (13. 33%) and arachnoid-pial meningeal enhancement in 2 cases. 12 cases of suppurative meningitis (n = 10) with suppurative meningitis (n = 10) with grade 鈪，

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