驱虫药脑病的MRI诊断价值及发病机制探讨

MRI Diagnosis and Pathogenesis of Anthelmintics-induced Multifocal Encephalopathy

目的 评价MRI对驱虫药脑病的诊断价值 ,探讨该病的发病机制。资料与方法 5 2例患者分 2组行MRI检查。第一组为临床初诊驱虫药脑病患者 2 2例 ,用MRI检查帮助诊断 ,总结最后确诊病例的MRI表现并探讨该病发病机制。第二组根据已总结的MRI征象随机诊断该病 30例 ,并与确诊病例数比较 ,判断MRI表现的诊断特异性。结果 与服驱虫药后偶合起病的其他疾病发病率约 2 7% (6 /2 2 ) ,MRI能诊断其中大部分疾病。驱虫药脑病的MRI表现大多类似脱髓鞘病变或散发性脑炎 ,其MRI诊断特异性约 6 3%。

Objective To evaluate MRI in the diagnosis of anthelmintics induced multifocal encephalopathy (AIME), and to explore the pathogenesis of the disease.Materials and Methods MRI was performed in 22 patients with clinically suspected AIME, and MRI features in the finally proved cases were analyzed. Another 30 patients, who were considered to be AIME based on the MRI findings observed in the proved cases of the above group, were studied for the evaluation of the specificity of MRI by comparing the total 30 with the number of the proved cases. Results Of 22 patients with clinically suspected AIME, the anthelmintic cause could not be confirmed in 6 (27%). The specificity of imaging features in AIME, which were similar to those signs observed in other demyelinating disorders or encephalitis, was about 63%.Conclusion MRI plays an important role in the diagnosis of AIME as well as in the study of its pathogenesis.