亚急性病毒性脑炎的早期MRI表现

The early MRI features of subacute virus encephalitis

目的探讨亚急性病毒性脑炎患者的早期MRI表现,提高认识水平及诊断水平,改善患者预后。方法对17例经临床综合确诊为亚急性病毒性脑炎患者的早期MRI表现进行回顾性分析。结果17例亚急性病毒性脑炎患者中16例脑部MRI有异常表现,其中15例为多发,1例为单发。MRI表现:(1)病变分布:16例均有皮层脑质受累,分别为局限于脑皮质者2例,皮质及皮质下白质均受累者14例,伴半卵圆中心区多发性病灶者3例;(2)病变形态:病变皮层脑质肿胀呈脑回样或点片状异常信号者6例,皮质及皮质下白质区同时受累融合呈斑片状异常信号者9例,半卵圆中心区腔隙性病灶呈串珠样分布者2例;皮质及皮质下白质融合呈大片状异常信号者1例;(3)病变信号:所有病例在DWI像上均呈异常高信号,T2WI及FLAIR序列呈略高或高信号,T1WI呈等或低信号;(4)增强扫描:6例行增强扫描均无异常强化。结论亚急性病毒性脑炎的早期MRI表现具有一定特征性,根据病变分布、形态及信号等特点,结合临床容易做出准确诊断。

Objective To investigate subacute virus encephalitis early MRI features so as to improve the diagnostic level of the disease. Methods To retrospectively analyze 17 cases clinical final diagnosis subacute virus encephalitis early MRI features. Results 16 of all 17 cases brain MRI had abnormal appearance, in which 15 cases had multi-focus, 1 case had single focus. The MRI finding： （ 1 ） affection disposition：brain mantle involved,2 cases located in brain mantle, 14 cases located in brain mantle and subcortical white,3 cases located in centrum ovale. （2）Affection form ：6 cases had gyrus-like or spot film abnormal signal in swelling substantia corticalis,9 cases had abnormal patching signal in both brain mantle and subcortical white, 2 cases had beading lacuna focus in centrum ovale, 1 case had largely lamellar abnormal signal in both brain mantle and subcortical white. （3）Affection signal： DWI showed high signal, T2WI and FLAIR sequence showed light high or high signal, T1WI showed equal or low signal. （4） Enhancement scanning ： 6 cases enhancement scanning had no abnormal enhancement. Conclusions Subacute virus encephalitis early MRI features had some characteristic, and final diagnosis was based on affection disposition, form, signal and clinical manifestation.