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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 To study the diagnostic value of diffusion weighted imaging (DWI) in children with viral encephalitis and its relationship with staging. Methods 56 patients with viral encephalitis diagnosed by Department of Pediatric Neurology, Shengjing Hospital Affiliated to China Medical University from June 2006 to February 2007 underwent conventional magnetic resonance imaging (MRI) and DWI, of which 29 cases were abnormal 13 cases made 2 head MRI. A total of 42 cases there are varying degrees of head MRI abnormalities. According to the difference between traditional MRI and DWI, the patients were divided into three groups, and the apparent diffusion coefficient (ADC) of ipsilateral lesion in each group was compared with contralateral normal brain tissue. Results The number of lesions and the range of lesions showed by DWI in group Ⅰ were better than those in MRI. The DWI of group Ⅱ was similar to that of MRI. The MRI of group Ⅲ was better than that of DWI. The average ADC values of the three groups of children with lesions and contralateral normal brain tissue were respectively: group Ⅰ (0.45 ± 0.19) × 10-3mm2 / s, normal (0.93 ± 0.06) × 10-3mm2 / s; group Ⅱ 0.87 ± 0.31) × 10-3mm2 / s, normal (0.97 ± 0.06) × 10-3mm2 / s; group Ⅲ (1.66 ± 0.60) × 10-3mm2 / s and normal (1.08 ± 0.24) × 10-3mm2 / s. The ADC value of group Ⅰ was significantly lower than that of group Ⅱ, and the ADC value of group Ⅲ was the highest (P <0.05). Conclusion DWI shows that the range and number of lesions in children with early encephalitis are better than MRI and DWI combined with MRI can determine the stage of disease.