病毒性脑炎的MRI诊断

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1、实用放射学杂志2006年7月第22卷第7期JPractRadiol,Jul2006,Vo.l22,No.7781病毒性脑炎的MRI诊断龚才桂,王小宜,刘慧(中南大学湘雅医院放射科,湖南长沙410008)摘要:目的探讨病毒性脑炎MRI表现特点及与急性播散性脑脊髓炎(ADEM)鉴别的可能性。方法分析56例病毒性脑炎及50例ADEM的脑部MRI表现,重点分析病毒性脑炎的脑部MRI表现。结果病毒性脑炎脑内有多发或单发的对称或不对称大片状病灶,主要位于皮层、皮层下及基底节-丘脑区,MRI呈长T1长T2信号,增强扫描27例,显示病灶强化者17例,其中呈大片状或脑回状强化者10例。ADEM则脑内

2、有多发不对称斑点、斑片状病灶,主要位于双侧脑室周围及额颞顶枕叶脑白质区,MRI呈长T1长T2信号,增强扫描20例,显示病灶强化者15例,均为环形或斑点状强化。结论MRI是诊断病毒性脑炎重要的辅助检查方法,可在一定程度上为临床的早期诊断及鉴别诊断提供依据。关键词:脑炎;病毒性;磁共振成像中图分类号:R512.3;R445.2文献标识码:A文章编号:1002-1671(2006)07-0781-04MRIDiagnosisofViralEncephalitisGONGCai-gui,WANGXiao-yi,LIUHui(DepartmentofRadiology,XiangyaHosp

3、ital,ZhongnanUniversity,Changsha410008,China)Abstract:ObjectiveTostudyMRIcharacteristicsofviralencephalitisandthepossibilityofdifferentiatingdiagnosiswithacutedis-seminatedencephalomyelitis(ADEM).MethodsMRIfindingsin56patientswithviralencephalitisand50patientswithADEMwereana-lysedandemphasized

4、onMRfindingsofviralencephalitis.ResultsTheabnormalsignallesionswerefoundin56patientswithviralenceph-alitis,includingmultipleorsingle,symmetricalorasymmetricallargepatchshapelesions,thelesionslocatedmainlyincortices,subcorticalandbasalgangliaandthalami.ThelesionsappearedaslongTandlongTonMRI.Enh

5、ancedMRIwasperformedin27cases,anddemon-12stratedabnormalenhancementin17cases,includinglargepatchorgyrusshapeenhancementin10cases.Multipleandasymmetricalspot-patchwhitematterlesionswererevealedinthefrontallobe,parietallobe,occipitallobe,temporallobe,andperiventricularareaswithADEM.Thelesionswer

6、elongT1andlongT2onMRI.EnhancedMRIwasperformedin20cases,anddemonstratedabnormalenhancementin15cases,peripheralring-typeorpatchshapeenhancementwasobservedinallcases.ConclusionMRIisoneoftheimportantmeth-odsindiagnosisofviralencephalitis,itcanprovideevidencesforearlydiagnosisanddifferentiationinth

7、ecertaindegree.Keywords:encephalitis;viral;MRI病毒性脑炎(viralencephalitis)是一种以脑实质炎例(男32例,女24例,年龄90d～64岁,平均23.5症出现症状和体征的严重疾病。MRI对病毒性脑炎具岁),ADEM50例(男23例,女27例,年龄7～60岁,有重要的诊断价值。MRI在显示病变以及了解病变累平均31.4岁)。所有病例均在发病2～13d内行第1及的部位、范围、程度、病灶强化的范围及形态等方面次MR