Wernicke脑病的MRI诊断价值

Diagnostic Value of Magnetic Resonance Imaging on Wernicke Encephalopathy

目的探讨颅脑MRI检查对Wernicke脑病(WE)的诊断价值。方法回顾性分析12例经临床证实的WE患者的临床及MRI检查资料。结果 12例WE患者,病变累及双侧丘脑内侧及第三脑室周围5例,中脑导水管周围、桥脑被盖4例,乳头体2例,双侧大脑脚1例。上述病例表现为等或稍长T1稍长T2信号5例,稍长T1长T2信号7例,信号边缘均模糊不清,4例中心区域信号欠均匀;FLAIR呈稍高或高信号。DWI呈明显高信号5例,4例ADC图呈低信号,1例高信号;DWI呈稍高信号4例,ADC图均呈低信号;2例DWI呈等信号,ADC图均呈稍低信号。结论 WE早期缺乏特征性临床表现,但具有典型的MRI表现,头颅MRI检查尤其是DWI,对于该病早期诊断及临床预后评估具有重要价值。

Objective To evaluate neurocranial MRI in the diagnosis of Wernicke encephalopathy （WE）. Methods The clinical and MR imaging data of 12 patients with clinically-proved WE were analyzed retrospectively. Results The lesions involved medial bilateral thalamus and the area around the third cerebral ventricle （5 cases）, the area around midbrain aqueduct and pontine tegmentum （4 cases）, mammillary body （2 cases） and bilateral cerebral peduncle （1 case）. The cases showed even or slightly longer T1, T2 signals in 5 cases, slightly longer T1 and T2 signals in 7 cases, with blurred signal edges, and the signals of central region were uneven in 4 cases. FLAIR had slightly hyperintense or hyperintcnse. DWI showed high signals in 5 cases with ADC map Of low signal in 4 cases and high signal of 1 case; DWI showed slightly hyperintense in 4 cases with all the ADC map of hypointense signals; DWI showed isointense with the ADC map of slightly hypointense. Conclusions Earlier period of Wemicke encephalopathy is lack of special clinical symptoms, but has definite MR imaging findings. Neurocranial MRI especially the DWI has an important role in early diagnosis and clinical prognostic evaluation of WE.