软脑膜（软膜-胶质板）的超声列线图及其在评估婴儿细菌性脑膜炎中的应用价值。
Sonographic nomogram of the leptomeninges (pia-glial plate) and its usefulness for evaluating bacterial meningitis in infants.
作者信息
Jéquier S, Jéquier J C
机构信息
Department of Pediatric Radiology, Children's Hospital, University Hospital of Geneva, Switzerland.
出版信息
AJNR Am J Neuroradiol. 1999 Aug;20(7):1359-64.
BACKGROUND AND PURPOSE
To our knowledge, the upper limits of the thickness of normal meninges on neurosonograms are not known. We therefore established a nomogram for sonographic measurements of the leptomeninges (pia-glial plate) and assessed its usefulness in neurosonographic examinations of children with bacterial meningitis.
METHODS
The pia mater-cortical glia limitans complex on the surface of the brain and in the sulcus of a frontal gyrus was measured on neurosonograms in 100 infants without meningeal disease in order to establish a nomogram of the thickness of this pia-glial plate, referred to as the leptomeninx. Effects of prematurity, age, sex, and single-layer (surface) versus double-layer (sulcus) measurements were analyzed. Meningeal thicknesses derived from a retrospective analysis of the neurosonograms of 33 patients with purulent meningitis and a prospective study of 22 patients with bacterial meningitis were compared with the nomograms. Clinical outcomes of children with meningeal thickening were compared with those of affected children with normal meninges.
RESULTS
The distribution of sulci measurements was significantly asymmetrical around the mean. Statistical data showed no influence of prematurity and sex, but showed surface measurements to be more consistent than sulcal measurements. Older chronological age was related to slightly larger sulci, but did not influence the surface measurements. In children with bacterial meningitis, the surface meninges were less frequently thickened than were the sulci. Sulcal enlargement occurred often in combination with echogenic deposits in the sub-arachnoid space.
CONCLUSION
Leptomeninges are best measured on the surface of a gyrus rather than in a sulcus, as the normal thickness of the sulci shows much more variability. Clinical outcome of bacterial meningitis cannot be predicted by presence or absence of meningeal thickening as the only sonographic abnormality.
背景与目的
据我们所知，正常脑膜在神经超声检查中的厚度上限尚不清楚。因此，我们建立了一个用于软脑膜（软膜 - 胶质板）超声测量的列线图，并评估其在细菌性脑膜炎患儿神经超声检查中的应用价值。
方法
对100例无脑膜疾病的婴儿进行神经超声检查，测量大脑表面和额回沟处的软脑膜 - 皮质胶质界膜复合体，以建立该软膜 - 胶质板（即软脑膜）厚度的列线图。分析早产、年龄、性别以及单层（表面）与双层（沟内）测量的影响。将33例化脓性脑膜炎患者神经超声检查的回顾性分析结果以及22例细菌性脑膜炎患者的前瞻性研究结果中得出的脑膜厚度与列线图进行比较。比较脑膜增厚患儿与脑膜正常的患病患儿的临床结局。
结果
沟内测量值围绕均值的分布明显不对称。统计数据显示早产和性别无影响，但表面测量比沟内测量更具一致性。实际年龄较大与稍大的脑沟有关，但不影响表面测量。在细菌性脑膜炎患儿中，表面脑膜增厚的情况比脑沟处少见。脑沟增宽常与蛛网膜下腔的回声沉积物同时出现。
结论
软脑膜最好在脑回表面而非脑沟处测量，因为脑沟的正常厚度变异性更大。细菌性脑膜炎的临床结局不能仅通过脑膜增厚这一唯一的超声异常表现来预测。
Zotero 插件