Wernicke脑病的临床与MRI诊断

Clinical and MR diagnosis of Wernicke′s encephalopathy

目的:探讨Wernicke脑病(WE)的MRI表现,提高对该病的认识。方法:回顾性分析8例WE患者的临床资料及MRI表现。结果:8例患者中4例于第三脑室旁、乳头体、丘脑内、导水管周围白质区呈对称性损害,2例以乳头体、四叠体损害为主,2例症状较重者,除上述部位信号异常外,其脑干及小脑内见广泛异常信号;所有病灶均表现为T1WI低信号、T2WI高信号、FLAIR序列明显高信号改变。4例患者治疗前后行DWI(b=1000s/mm2)检查显示病灶呈高、等信号,3例治疗前ADC值下降,1例无变化,治疗后ADC值均升高。结论:WE的MRI表现具有特征性,MRI及DWI对该病的早期和进展期患者的诊断和判断预后具有重要价值。

Objective：To analyze the neuroimaging findings of patients with Wernicke′s encephalopathy（WE） on MR images.Methods：MR brain imaging findings and clinical presentations of 8 patients with Wernicke′s encephalopathy were retrospectively reviewed.Results：4 of 8 patients showed symmetric alterations in the medial thalami,periventricular region of the third ventricle,periaqueductal area,mamillary bodies and tectal plate.2 of 8 patients showed lesions in the mamillary bodies and quadrigeminal bodies.Besides the above-mentioned lesions,extensive abnomal-signals were found also in the brain stem and cerebellum in two severe cases.At MR examination,T1-weighted conventional images showed low signal intensity,T2-weighted images showed high signal intensity.FLAIR images showed increased signal intensities（b=1000s/mm2）.Diseased regions showed high or identical signal intensity both before and after treatment on diffusion-weighted imaging（DWI） in 4 cases.The ADC value of diseased regions increased after treatment in all patients.Conclusion：Wernicke＇s encephalopathy is characterized by a quite distinct pattern of MR alterations.A thorough knowledge of the neuroimaging findings of Wernicke＇s encephalopathy will assist in arriving at an early diagnosis.