Wernicke脑病的磁共振表现及其临床特点

Clinical features and MRI findings of wernicke encephalopathy

目的探讨Wernicke脑病的临床特点及影像学MRI表现。材料与方法回顾性分析我院2010年2月至2015年6月经临床确诊的10例Wernicke脑病患者的临床及MRI影像资料。结果 10例患者中表现为意识障碍及精神症状者3例,视力障碍或眼肌麻痹者3例,共济失调者4例。10例均行MRI检查。10例患者中,6例患者表现为双侧丘脑内侧、第三、四脑室旁、中脑导水管周围出现,长T1WI信号,长T2WI信号,T2 FLAIR高信号;2例患者乳头体、穹隆柱出现对称性长T1WI信号,长T2WI信号,T2 FLAIR高信号;2例患者桥脑背盖、乳头体、中央导水管周围、双侧中央沟皮质出现对称性长T1WI信号,长T1WI信号,T2FLAIR高信号,弥散加权成像(diffusion weighted imaging,DWI)高信号。结论Wernicke脑病MRI具有一定特征性的表现,结合临床资料及临床症状可对本病作出早期的正确诊断。

Objective： To investigate the clinical and MR imaging features of wernicke encephalopathy（WE）. Materials and Methods： Retrospective analysis in February 2010 to June 2015, the clinical diagnosis of 10 cases of wernicke encephalopathy in patients with clinical and MRI image data. Results： Three of ten patients showed changes in consciousness and psychiatric syptoms, Three patients had ocular manifestations, and four had ataxia. On MR imaging, six patients had evidence of symmetric lesions in the medial thalami and in the periventricular region of the third or four ventricle, and in periaqueductal area. Two patients had evidence of mamillary bodies, column of the fornix; Two patient had evidence of tectal plate, mamillary bodies, periaqueductal area, bilateral signal-intensity alterations of the pre- and postcentral cortex. The imaging findings were hyperintensity on T2-weighted or T1- weighter and fluid-attenuated inversion recovery （FLAIR） images. Conclusion： Contrast enhancement in the mamillary bodies and thalamus is a typical finding of the disease in WE patients. MR imaging has a valuable diagnostic role in diagnosing early WE except for clinical symptoms.