单纯疱疹病毒性脑炎的CT及MRI表现

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1、万方数据276放射学实践20l4年3月第29卷第3期RadiolPractice，Mar20111y!l；!!盥!．!单纯疱疹病毒性脑炎的CT及MRI表现张岩岩，李云芳，王杏，李宏军中枢神经影像学【摘要】目的：探讨单纯疱疹病毒性脑炎的影像学表现。方法：回顾性分析9例经PCR(polymerasechainreaction)证实的单纯疱疹病毒性脑炎患者的影像及临床资料，9例患者均行颅脑MRI及增强检查，3例行头部CT扫描。结果：2例病灶位于单侧颞叶、岛叶和扣带回；2例位于双侧颞叶，岛叶、基底节、额叶内侧回及海马钩回；5例位于双侧额

2、叶、颞叶、岛叶，一侧为重，病灶多累及皮层及皮层下白质；其中2例出现不同程度的占位效应。CT扫描病灶呈低密度；MRI扫描病灶呈长T、长T2信号，TlRM序列上病灶呈高信号，DwI显示病灶区扩散受限，增强扫描5例出现脑膜样强化，4例无强化。结论：单纯疱疹病毒性脑炎影像学表现具有一定特征性，常侵犯颞叶、额叶、基底节及岛叶，尤其一侧颞叶、岛叶和眶额区为重。MRI对病灶的显示优于CT。【关键词】单纯疱疹病毒性脑炎；体层摄影术，x线计算机；磁共振成像【中图分类号】R445．2；R445．3；R512．3【文献标识码】A【文章编号】1000一

3、0313(2014)030276一03CTandMRImanifestationsofherpessimplexvirusencephalitisZHANGYan—yan，LlYun—fang，WANGXing，eta1．Depart—mentofRadiology，BeijingYouanHospital，CapitalMedicalUniversity，Be巧ing100069，P．R．China【Abstract】Objective：Toinvestigatethejmagingappearanceofherpessimp

4、jexvirusencephaiitis．Methods：ImagingandclinicaldatafromninepatientswithherpessimplexvirusencephahtisprovedbyPCRwereretrospectiVelyanalyzed．Ninepatientsa11receivedMRIanddynamiccon”astenhancementscanningand3receivedCTscanning．Results：Themajori—tyof1esionswerelocatedint

5、heunilateraltemporallobe，insuIaandcingulategyrus(n一2)“ilateraltemporallobe，insularlobe，basalganglia，medialfrontalgyrusandthehippocampaluncus(n一2)，orbilateralfrontallobe，temporallobe，insularlobe，withonesideheavier，lesionsmostlyinvolvingthecortexandsubcorticalwhitematt

6、er(n一5)；amongthem2caseshaddifferentdegreeofoccupyingeffect．CTscanshowedlowdensity．MRIscanshowed10ngT1andlongT2signalintensity，TIRMsequenceshowedhighsignaI，DWIshowedrestricteddiffusion，enhancedscansh。wedmildmeningealenhancement(n=5)ornonenhancement(n一4)．Conclusions：He

7、rpessimplexvirusencephalitisofteninvolvesonesideofthebrain，especiallytemporallobe，insularandorbitofrontalareawithasymmetricdistribution．Astotheimagingmanifestations，MRlisbetterthanCT．【Keywords】Herpessimplexvirusencephalitis；Tomography，X—raycomputed；Magneticresonancei

8、maging单纯疱疹病毒性脑炎(herpessimplexvirusen—cephaljtis，HSE)是由单纯疱疹病毒(herpessimplexvirus，HSV)直接侵犯中枢神经系统所引起的重症脑炎，病毒常侵犯一侧脑组织，尤其一侧颞叶，岛叶和眶额区，分布不