Acute Flaccid Paralysis in Infants and Young Children with Enterovirus 71 Infection: MR Imaging Findings and Clinical Correlates
Cheng-Yu Chen
,a,
Ying-Chao Changa,
Chao-Ching Huanga,
Chun-Chung Luia,
Kwo-Wei Leea and
Song-Chei Huanga
a From the Departments of Radiology and Pediatrics, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan (C.Y.C., K.W.L.); the Department of Pediatrics and Diagnostic Radiology, Chang Gung Children's Hospital, Kaohsiung, Taiwan (Y.C.C., C.C.L., S.C.H.); and the Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan (C.C.H.).
View larger version (91K):
[in a new window]
|
FIG 1. Unilateral AFP and transient urinary retention in 18-month-old girl with lumbosacral radiculomyelitis.
A, Contrast-enhanced axial T1-weighted image (752/15/1) at L1 level shows strong enhancement of the left ventral root (arrowhead) and mild enhancement of the left anterior horn cells (arrow) of the sacral cord.
B, Left anterior horn lesion (arrow) is inconspicuous on gradient-echo T2-weighted image (808/18/20).
| |
View larger version (130K):
[in a new window]
|
FIG 2. Radiculomyelitis causing bilateral AFP and urinary retention.
A, Unenhanced axial T1-weighted image (752/15) shows hypointense lesions (arrowheads) in the anterior horn cells of spinal cord bilaterally at T11 level.
B, Contrast-enhanced T1-weighted image at the same level as in A shows predominant enhancement of the ventral roots (arrowheads). The anterior horn cell lesions do not enhance.
C, Contrast-enhanced T1-weighted image at the conus level clearly shows the predominant ventral root enhancement. The slightly hyperintense dot at the left dorsal root region (arrowhead) is probably due to enhancement of the radicular vein.
D, The anterior horn cell lesions are hyperintense and more conspicuous on gradient-echo T2-weighted image (808/15/20) as compared with T1-weighted image (A).
E, Sagittal fast spin-echo T2-weighted image (2300/103/2) shows the extent of the anterior horn cell lesions (arrowheads) from midthoracic to conus levels.
| |
View larger version (109K):
[in a new window]
|
FIG 3. Persistent weakness of right lower limb 2 months after EV71 infection in a 16-month-old infant.
A, Axial fast spin-echo T2-weighted image (4000/80/3) at lumbosacral cord 2 months after acute paralysis shows a hyperintense lesion in the right anterior horn region (arrow).
B, Sagittal fast spin-echo T2-weighted image shows a long-segment hyperintense lesion (arrowheads) extending from the lower thoracic to the lumbosacral levels.
| |
