Relationship Between MRI Manifestations And The Recovery Of Japanese Encephalitis In Children

Objective: A retrospective analysis of the cranial magnetic resonance imaging(MRI)of children with DOC lasting for more than 2 weeks in Japanese encephalitis was performed to investigate the relationship between MRI findings and recovery of consciousness in children.Methods: The clinical data of 76 children with DOC lasting for more than 2 weeks of Japanese encephalitis who were admitted to the Rehabilitation Department of Children’s Hospital of Chongqing Medical University from July 2013 to September 2017 are collected.The performance of the cranial MRI was divided into 3 grades according to the following criteria: Grade I: no abnormal lesions were found;Grade II:bilateral thalamic lesions with or without bilateral basal ganglia and cerebral cortex lesions;Grade III: lesions involving the brainstem.The children who completed the MRI examination within 2 weeks were divided into one group.The children who completed the MRI examination after 2 weeks were divided into another group.The relationship between MRI classification,consciousness recovery rate,consciousness recovery time and prognosis was analyzed.The outcome of awakening after6-month course of the disease was used as the criterion.According to the CRS-R scale,the ability to perform functional communication or functional use is judged to be awake.Results:1.The cranial MRI showed that the conscious recovery rate of children with no damage in basal ganglia,brainstem and cerebral cortex was higher than that in children with damage in above areas(P<0.05).2.The recovery rate of consciousness in all children was 43.42% in one month,77.63% in three months,and 81.57% in six months.For children who can regain consciousness,the increase in MRI grade has nothing to do with the duration of DOC(P>0.05).In patients who completed MRI examination within 2 weeks,the grading of MRI was not associated with the recovery of consciousness(P>0.05),The higher the grade,the lower the recovery rate of consciousness was in the patients who completed the MRI examination after 2 weeks(P<0.05).3.Four of the 44 patients who were successfully followed up for at least 1 year were died and 15 returned to normal.The remaining 25 patients had varying degrees of dysfunction,including motor disorder,language disorder,secondary epilepsy,intellectual disorder and emotional disorder.The higher the grade of GOS,the lower the rate of the prognosis rate.Conclusion: The performance of MRI can objectively and accurately reflect the degree of brain damage in Japanese encephalitis.The damage of basal ganglia,cerebral cortex and brain stem of children with Japanese encephalitis is related to the recovery of consciousness.MRI examination performed after 2 weeks showed a significant correlation between the classification and the recovery of consciousness.The prognosis can be predicted by the grading of MRI.The higher the MRI grade,the worse the prognosis.