患有视网膜病变阴性脑型疟疾儿童的脑部磁共振成像
Brain MRI of children with retinopathy-negative cerebral malaria.
作者信息
Postels Douglas G, Li Chenxi, Birbeck Gretchen L, Taylor Terrie E, Seydel Karl B, Kampondeni Sam D, Glover Simon J, Potchen Michael J
机构信息
International Neurologic and Psychiatric Epidemiology Program, Michigan State University, East Lansing, Michigan; Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan; Department of Neurology, University of Rochester, Rochester, New York; Blantyre Malaria Project, University of Malawi College of Medicine, Blantyre, Malawi; College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan; Department of Radiology, Queen Elizabeth Central Hospital, Blantyre, Malawi; Department of Anatomy, University of St. Andrews, St. Andrews, Scotland; Department of Imaging Sciences, University of Rochester, Rochester, New York
International Neurologic and Psychiatric Epidemiology Program, Michigan State University, East Lansing, Michigan; Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan; Department of Neurology, University of Rochester, Rochester, New York; Blantyre Malaria Project, University of Malawi College of Medicine, Blantyre, Malawi; College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan; Department of Radiology, Queen Elizabeth Central Hospital, Blantyre, Malawi; Department of Anatomy, University of St. Andrews, St. Andrews, Scotland; Department of Imaging Sciences, University of Rochester, Rochester, New York.
出版信息
Am J Trop Med Hyg. 2014 Nov;91(5):943-9. doi: 10.4269/ajtmh.14-0216. Epub 2014 Sep 8.
Our goals were to understand the brain magnetic resonance imaging (MRI) findings in children with retinopathy-negative cerebral malaria (CM) and investigate whether any findings on acute MRI were associated with adverse outcomes. We performed MRI scans on children admitted to the hospital in Blantyre, Malawi with clinically defined CM. Two hundred and seventeen children were imaged during the study period; 44 patients were malarial retinopathy-negative; and 173 patients were retinopathy-positive. We compared MRI findings in children with retinopathy-negative and retinopathy-positive CM. In children who were retinopathy-negative, we identified MRI variables that were associated with death and adverse neurologic outcomes. On multivariate analysis, cortical diffusion weighted imaging (DWI) abnormality and increased brain volume were strongly associated with neurologic morbidity in survivors. Investigations to explore the underlying pathophysiologic processes responsible for these MRI changes are warranted.
我们的目标是了解视网膜病变阴性的儿童脑型疟疾（CM）的脑磁共振成像（MRI）表现，并调查急性MRI上的任何表现是否与不良结局相关。我们对马拉维布兰太尔医院收治的临床诊断为CM的儿童进行了MRI扫描。在研究期间对217名儿童进行了成像；44例患者为疟疾视网膜病变阴性；173例患者为视网膜病变阳性。我们比较了视网膜病变阴性和阳性CM患儿的MRI表现。在视网膜病变阴性的儿童中，我们确定了与死亡和不良神经结局相关的MRI变量。多因素分析显示，皮质扩散加权成像（DWI）异常和脑容量增加与幸存者的神经疾病发病率密切相关。有必要进行调查以探索导致这些MRI变化的潜在病理生理过程。
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