Smith Nicholas, Pereira John, Grattan-Smith Padraic
Departments of Neurology and Medical Imaging, Sydney Children's Hospital, Randwick, New South Wales, Australia.
J Paediatr Child Health. 2014 Oct;50(10):E72-6. doi: 10.1111/j.1440-1754.2010.01802.x. Epub 2010 Jul 7.
To review the role of gadolinium-enhanced magnetic resonance imaging of the spine in the diagnosis of paediatric Guillain-Barre syndrome and compare it with nerve conduction studies and cerebrospinal fluid analysis.
A retrospective review of investigations undertaken in children admitted to our institution with acute Guillain-Barre syndrome over a 10-year period was performed.
Seven of eight children (88%) displayed post-gadolinium nerve root enhancement consistent with Guillain-Barre syndrome. This compared with supportive nerve conduction studies in 21/24 children (88%) and cerebrospinal fluid protein analysis consistent with the diagnosis in 16/20 children (80%).
Nerve conduction studies are the recognised 'gold standard' technique for confirming a clinical diagnosis of Guillain-Barre syndrome. In this study, a high positive rate was demonstrated. While more experience is necessary, this study and the literature support gadolinium enhanced magnetic resonance imaging of the spine as a valuable, although not necessarily superior, investigation in the diagnosis of Guillain-Barre syndrome. It may be of particular benefit when specialist neurophysiology expertise is unavailable.
回顾脊柱钆增强磁共振成像在小儿吉兰-巴雷综合征诊断中的作用，并将其与神经传导研究及脑脊液分析进行比较。
对我院10年间收治的急性吉兰-巴雷综合征患儿的检查进行回顾性分析。
8例患儿中有7例（88%）钆增强后神经根强化，符合吉兰-巴雷综合征表现。与之相比，24例患儿中有21例（88%）神经传导研究结果支持诊断，20例患儿中有16例（80%）脑脊液蛋白分析结果符合诊断。
神经传导研究是确诊吉兰-巴雷综合征临床诊断的公认“金标准”技术。本研究显示其阳性率较高。虽然还需要更多经验，但本研究及文献均支持脊柱钆增强磁共振成像作为诊断吉兰-巴雷综合征的一项有价值的检查，尽管不一定更具优势。当缺乏专业神经生理学专业知识时，它可能特别有用。
