驱虫药脑病的临床特点和MRI诊断价值

Clinical Features and MRI Diagnostic Values of Anthelmintics Induced Multifocal Encephalopathy

目的探讨驱虫药脑病的临床特点和MRI诊断价值。方法选取我院2002年6月—2009年12月收治的20例驱虫药脑病患者为研究对象,患者均经过脑脊液、脑电图、CT及MRI检查结合临床表现确诊,总结该组患者发病的临床表现及影像学特征,比较CT与MRI诊断的符合率。结果驱虫药脑病的MRI表现大多类似脱髓鞘病变或散发性脑炎,MIR检查的诊断率与CT的诊断率比较,差异有统计学意义(P<0.05)。采用泼尼龙冲击治疗的总有效率为90.0%。结论 MRI检查对驱虫药脑病的诊断有重要意义,肾上腺皮质激素对治疗驱虫药脑病有很好的疗效,有利于降低患者的致残率和病死率。

Objective To investigate the clinical features and MRI diagnostic values of anthelmintics induced multifocal encephalopathy.Methods A total of 20 cases of anthelmintics induced multifocal encephalopathy patients treated by our hospital from June 2002 to December 2009 were enrolled.All subjects were diagnosed through cerebrospinal fluid examination,electroencephalogram examination,CT and MRI combined with clinical manifestations.Clinical manifestations and imaging features were summarized among these patients,with their MRI and CT diagnostic accuracy compared.Results MRI manifestations of anthelmintics induced multifocal encephalopathy resembled mostly demyelinated lesions or sporadic encephalitis,with significant difference in diagnostic accuracy compared with CT imaging（P0.05）.Pulse therapy of prednisolone showed an effective rate of 90.0%.Conclusion MRI can be of great significance in diagnosis of anthelmintics induced multifocal encephalopathy,which showed good response to steriod therapy with reduced morbidity and mortality.