儿童脑裂头蚴病MRI诊断

MRI diagnosis of cerebral sparganosis in children

摘要:

目的：探讨MRI对儿童脑裂头蚴病的诊断价值。方法：搜集经临床确诊的儿童脑裂头蚴病17例，回顾性分析其脑部的MRI表现，部分病例与手术及病理结果对照，同时回顾性分析该病就诊时的诊断符合率及统计两位影像学医生在掌握该病特征性影像学表现前后诊断检出率的变化。结果：增强扫描12例，病灶均显示强化，8例病灶呈环形、串珠状或匐行管状强化。7例MRI复查发现2例病灶强化的位置及形态有改变。病灶匐行管状、串珠状、扭曲条索状强化及随访病例病灶位置及形态的改变是儿童脑裂头蚴病MRI典型征象；17例脑裂头蚴病患儿临床首诊时、行第一次影像学检查后及随访后多次影像学检查后的诊断符合率分别为0%、11.8%和28.6%。两位影像学医生在掌握该病特征性影像学表现后诊断检出率提高到64.7%、70.6%与 85.7%。结论： 儿童脑裂头蚴病的脑部MRI表现具有一定的特征性，正确把握该病典型的影像学表现对减少临床误诊率有很大帮助。

Abstract:

ObjectiveTo study the value of MRI in the diagnosis of cerebral sparganosis in children.MethodsThe MRI appearances of 17 children with cerebral sparganosis proven by pathology or serological test were retrospectively studied. The diagnostic accuracy rate of cerebral sparganosis was compared before and after knowing the imaging features of this disease.ResultsEnhanced MRI was performed in 12 cases, and all of them demonstrated abnormal enhancement. Peripheral ring-type, tortuous beaded shape or serpiginous tubular shape enhancement were found in 8 cases. After analysis of follow-up MRI for 7 cases, a change in location and shape of lesions was found in 2 cases. Typical MRI patterns of cerebral sparganosis included abnormal enhancement such as peripheral ring-type, tortuous beaded shape or serpiginous tubular shape enhancement, and changes in location and shape of lesions in the follow-up MRI. The diagnostic accuracy rate for the 17 cases of cerebral sparganosis at the first visit, after first imaging examination and after several follow-up MR examinations were 0%, 11.8% and 28.6%, respectively. The diagnostic accuracy rate of this disease increased to 64.7%, 70.6% and 85.7% respectively after the radiologists were trained in the imaging characteristics of the disease.ConclusionsMR findings in children with cerebral sparganosis are specific. Mastering correctly the typical imaging features of the disease can be very helpful in reducing the rate of clinical misdiagnosis.