【摘要】 目的 探究磁共振成像(MRI)联合视频脑电图(VEEG)在小儿病毒性脑炎诊断中的应用研究。方法 纳入2022年8月至2024年6月收治的68例小儿病毒性脑炎患儿作为脑炎组，纳入同期收治的68例热性惊厥患儿作为对照组。对比脑炎组与对照组基线资料与临床指标，统计脑炎组患儿临床症状与体征；对比脑炎组与对照组MRI与VEEG异常率，VEEG及MRI影像学特征，并分析MRI联合VEEG对小儿病毒性脑炎的诊断价值。结果 脑炎组病程、部分症状(头痛、呕吐、意识障碍、嗜睡、抽搐、精神异常发生率)显著高于对照组(P<0.05)，而PCIS显著低于对照组(P<0.05)；脑炎组MRI与VEEG检查异常率显著高于对照组(P<0.05);68例病毒性脑炎患儿中，29例(42.65%)出现MRI异常，临床表现出脑实质异常信号(T1W1低信号，T2WI高信号，FLAIR序列对症显示优于加权成像)，单侧局限病灶14例，双侧病灶5例，3处病灶4例，脑室扩张4例，脑外间隙增宽2例。68例病毒性脑炎患儿中，36例(52.94%)出现VEEG异常，活动背景节律变慢26例，局灶性高波幅θ、δ波，一侧或两侧半球受累10例；68例病毒性脑炎患儿MRI异常29例，正常39例。VEEG异常36例、正常32例；一致性检验显示，MRI与VEEG诊断儿童病毒性脑炎的一致性分析Kappa值为0.679，两者联合诊断异常51例，正常17例，诊断异常率更高(P<0.05)。结论 MRI与VEEG对小儿病毒性脑炎均有一定辅助诊断价值，两者联合诊断价值更高。更多还原

【Abstract】 Objective To explore the application of magnetic resonance imaging(MRI) combined with video electroencephalogram(VEEG) in the diagnosis of viral encephalitis in children.Methods 68 children with viral encephalitis admitted from August 2022 to June 2024 were included in encephalitis group,and 68 children with febrile convulsion during the same period were enrolled as control group.The baseline data and clinical indicators were compared between encephalitis group and control group,and the clinical symptoms and signs of encephalitis group were counted.The abnormal rates of MRI and VEEG and imaging features of VEEG and MRI were compared between encephalitis group and control group,and the diagnostic value of MRI combined with VEEG on children with viral encephalitis was analyzed.Results The disease course and incidence rates of some symptoms(headache,vomiting,disturbance of consciousness,drowsiness,convulsions,mental disorders) in encephalitis group were significa ntly higher than those in control group(P<0.05) while PCIS was significantly lower than that in control group(P<0.05).The abnormal rates of MRI and VEEG were significantly higher in encephalitis group than those in control group(P<0.05).Among the 68 children with viral encephalitis,29 cases(42.65%) had MRI abnormalities,and the clinical manifestations showed abnormal signals of brain parenchyma(T1W1 low signal,T2WI high signal,FLAIR sequence symptomatic display better than weighted imaging).There were 14 cases of unilateral localized lesions,5 cases of bilateral lesions,4 cases of 3 lesions,4 cases of ventricular dilatation,and 2 cases of extracerebral space widening.Among the 68 children with viral encephalitis,36 cases(52.94%) had abnormal VEEG,26 cases had slow activity background rhythm,focal high amplitude θ and δ waves,and 10 cases had unilateral or bilateral hemisphere involvement.Among 68 children with viral encephalitis,29 cases had abnormal MRI and 39 cases had normal MRI,and there were 36 cases of abnormal VEEG and 32 cases of normal VEEG.Consistency test showed that the consistency analysis Kappa value of MRI and VEEG in the diagnosis of viral encephalitis in children was 0.679.The combined diagnosis revealed that 51 cases were abnormal and 17 cases were normal,and the abnormal rate of diagnosis was higher(P<0.05).Conclusion Both MRI and VEEG have certain auxiliary diagnostic value on viral encephalitis in children,and the combined diagnostic value of the two is higher.更多还原