病毒性脑干脑炎合并脑动脉炎的磁共振成像特征

MR imaging features of viral brainstem encephalitis complicated with cerebral arteritis.

目的探讨病毒性脑干脑炎合并脑动脉炎的磁共振成像(MRI)特征。方法回顾性分析经临床和MRI证实的脑干病毒性感染20例临床影像资料。所有患者均行常规T1WI、T2WI、液体衰减反转回复序列(FLAIR)检查,其中增强磁共振血管成像(MRA)检查11例。结果脑干病毒感染性病变位于延髓8例,脑桥13例,中脑5例;病灶单发7例,多发13例;病灶表现为长T1长T2信号。2例椎基底动脉FLAIR显示高信号,增强MRA显示椎基底动脉信号丢失或血管狭窄。结论 FLAIR与增强MRA相结合可以评估椎基底动脉的形态和血液动力学,可在一定程度上为临床的早期诊断脑血管炎及其鉴别诊断提供依据。

Objective To explore MR imaging features of viral brainstem encephalitis complicated with cerebral arteritis.Methods MR images and clinical manifestation of 20 cases of viral brainstem encephalitis were retrospectively reviewed.All the cases had routine MR examination through T1WI,T2WI and fluid-attenuated inversion recovery（FLAIR）,11 of them also underwent contrast-enhanced MRA（CE-MRA）.Results The abnormal signal lesions were found in medulla oblongata in 8 cases,in pons in 13 cases and in midbrain in 5 cases,including 7 cases with single lesion and 13 cases with multiple lesions.The lesions appeared as long T1and long T2 signal on MRI.Two of 11 cases had evidence of basilar artery hyperintense on FLAIR and stenosis or signal loss on CE-MRA.Conclusion FLAIR combined with CE-MRA can be used to assess patterns and hemodynamics of basilar artery.It may provide some evidence for early clinical differential diagnosis of cerebral vasculitis.