Department of Radiology, Hospital de Base, São José do Rio Preto Medical School, São Paulo, State, 15090-000, Brazil.
Pediatr Radiol. 2010 Dec;40 Suppl 1:S138-40. doi: 10.1007/s00247-010-1650-6. Epub 2010 May 4.
Although acute flaccid paralysis is a manifestation observed in several neurologic and muscular disorders, vaccine-associated paralytic poliomyelitis (VAPP) is an exceedingly rare etiology. In the clinical setting of acute flaccid paralysis, MRI is useful in differentiating between VAPP and other conditions. Additionally, MRI can assess the extent of lesions. However, reports on MRI findings in VAPP are scarce in the pediatric radiology literature. We report a Brazilian infant who developed VAPP 40 days after receiving the first dose of oral polio vaccine (OPV). MR images of the cervical and thoracic spinal cord showed lesions involving the anterior horn cell, with increased signal intensity on T2-weighted sequences. We would like to emphasize the importance of considering VAPP as a differential diagnosis in patients with acute flaccid paralysis and an MRI showing involvement of medulla oblongata or spinal cord, particularly in countries where OPV is extensively administered.
虽然急性弛缓性麻痹是几种神经和肌肉疾病的表现，但疫苗相关麻痹性脊髓灰质炎（VAPP）是一种极为罕见的病因。在急性弛缓性麻痹的临床环境中，MRI 有助于区分 VAPP 和其他情况。此外，MRI 可以评估病变的范围。然而，儿科放射学文献中关于 VAPP 的 MRI 发现的报告很少。我们报告了一名巴西婴儿，他在接受第一剂口服脊髓灰质炎疫苗（OPV）后 40 天发生 VAPP。颈椎和胸椎脊髓的 MRI 图像显示前角细胞受累的病变，T2 加权序列上信号强度增加。我们想强调在 MRI 显示延髓或脊髓受累的急性弛缓性麻痹患者中，将 VAPP 作为鉴别诊断的重要性，特别是在广泛使用 OPV 的国家。
