新生儿不同病原菌化脓性脑膜炎在磁共振影像学上的特点

MRI findings of neonatal purulent meningitis caused by different pathogenic bacteria

摘要:

目的：探讨不同病原菌感染的新生儿化脓性脑膜炎（简称化脑）患儿的头颅磁共振（MRI）成像特点。方法：回顾性分析2005年1月到2012年2月住院治疗并行头颅MRI检查的58例新生儿化脑患儿的临床资料，对其病原体及影像学表现进行分析。结果：58例新生儿化脑患儿中首次头颅MRI检查出现神经系统并发症的有44例，发生率76%。革兰阴性菌感染以大肠杆菌感染最常见（6例），其头颅MRI表现为脑室膜炎4例，硬膜下积液1例，脑梗死1例；革兰阳性菌感染以李斯特菌居多（3例），头颅MRI均表现为不同程度的脑白质损伤。结论：不同病原体感染化脑的MRI成像表现不同，提示不同病原体感染化脑在MRI上的表现特点有助于临床诊断及治疗。

Abstract:

OBJECTIVE: To study the image characteristics of neonatal purulent meningitis caused by different pathogenic bacteria, using conventional magnetic resonance imaging (MRI). METHODS: The clinical data of 58 hospitalized newborns with purulent meningitis receiving MRI examination from January 2005 to February 2012 were retrospectively studied. Pathogens and MRI findings were investigated. RESULTS: Of the 58 newborns, 44 (76%) showed complications of the neural system on the first MRI. Escherichia coli were found as the most common pathogen in newborns with Gram-negative bacteria-induced purulent meningitis (six cases). Of the six cases, four presented with ventriculitis, one with subdural effusion and one with brain infarction on MRI. Listeria monocytogenes was frequently seen in newborns with Gram-positive bacteria-induced purulent meningitis (three cases). All three cases presented with different degrees of white matter damage on MRI. CONCLUSIONS: Neonatal purulent meningitis caused by different pathogenic bacteria has different image characteristics. This suggests that understanding the patterns of MRI findings is useful in the clinical diagnosis and treatment of neonatal purulent meningitis caused by different pathogens.