Department of Radiology, People's Hospital of Hainan Province, Haikou, PR China.
Asian Pac J Trop Med. 2013 Jan;6(1):68-72. doi: 10.1016/S1995-7645(12)60203-X.
To investigate clinical and neuroimaging features of enterovirus71 (EV71) related acute flaccid paralysis in patients with hand-foot-mouth disease.
Nine patients with acute flaccid paralysis met the criterion of EV71 induced hand-foot-mouth disease underwent spinal and brain MR imaging from May 2008 to Sep 2012.
One extremity flaccid was found in four cases (3 with lower limb, 1 with upper limb), two limbs flaccid in three cases (2 with lower limbs, 1 with upper limbs), and four limbs flaccid in two cases. Spinal MRI studies showed lesion with high signal in T2-weighted images (T2WI) and low signal T1-weighted images (T1WI) in the spinal cord of all nine cases, and the lesions were mainly in bilateral and unilateral anterior horn of cervical spinal cord and spinal cord below thoracic 9 (T9) level. In addition, the midbrain, pons, and medulla, which were involved in 3 cases with brainstem encephalitis, demonstrated abnormal signal. Moreover, spinal cord contrast MRI studies showed mild enhancement in corresponding anterior horn of the involved side, and strong enhancement in its ventral root.
EV71 related acute flaccid paralysis in patients with hand-foot-mouth disease mainly affected the anterior horn regions and ventral root of cervical spinal cord and spinal cord below T9 level. MR imaging could efficiently show the characteristic pattern and extent of the lesions which correlated well with the clinical features.
探讨肠道病毒 71 型（EV71）相关手足口病急性弛缓性麻痹的临床和神经影像学特征。
2008 年 5 月至 2012 年 9 月，9 例符合肠道病毒 71 型手足口病诊断标准且伴有急性弛缓性麻痹的患者接受了脊髓和脑部磁共振成像检查。
4 例患者出现单肢弛缓（3 例下肢，1 例上肢），3 例患者出现双肢弛缓（2 例下肢，1 例上肢），2 例患者出现四肢弛缓。脊髓 MRI 研究显示，9 例患者的脊髓均存在 T2 加权成像（T2WI）高信号和 T1 加权成像（T1WI）低信号病变，病变主要位于双侧和单侧颈髓前角及胸 9（T9）以下脊髓。此外，3 例伴有脑干脑炎的患者中，中脑、脑桥和延髓也存在异常信号。而且，脊髓对比磁共振成像研究显示，受累侧相应前角轻度强化，其腹根明显强化。
手足口病相关的 EV71 急性弛缓性麻痹主要影响颈髓前角区和 T9 以下脊髓以及腹根。磁共振成像能够有效地显示病变的特征性模式和范围，与临床特征具有良好的相关性。
