钩体性脑动脉炎的CT所见(附28例报告)

A CT study on leptospiral cerebral arteritis:an analysis of 28 cases.

分析28例钩体性脑动脉炎的CT所见,结果显示梗塞灶位于大脑半球,主要呈多发性和/或双侧性分布,超过半数位于供血交界区。其中7例行脑动脉造影有不同程度闭塞。钩体性脑动脉炎主要表现为大脑半球的双侧性和/或多发性,交界性的中小梗塞,可能同受累动脉很少完全闭塞或侧支循环较丰富有关。这种特点有助于鉴别诊断。6例作增强CT扫描,其中有4例呈现皮层脑回状强化,且位于无梗塞灶侧的局限性皮质萎缩处,提示可能有或发生过小梗塞。在怀疑本病时应进行增强CT扫描及血清学检查,以便及早确诊。

The authors analyzed 28 cases of leptospiral cerebral arteritis in a CT study. The low-density focuses showed by CT scans mainly manifested multiple or/ and bilateral distributions in brain. Themajority of these lesions was located at the borderline areas of the blood supply. 7 cases. undergone carotid angiography or DSA showed various degrees of occlusion. It was suggested that leptospiral cerebral arteritis appeared mainly medium or small, bilateral and/or multiple infarcts in cerebrum, which may be associated with the incomplete occlusion in affected arteries or with rich collateral circulation. This characteristics was helpful for the differential diagnosis. Among 6 cases with contrast CT examination, 4 cases revealed intensive enhancement of many cortical vessels in the local cortical atrophy areas without infarcts, suggesting that some small infarcts might have developed in. The authors indicated that it is necessary to have contrast CT scans and serologic test for the case who was suspected to be leptospiral cerebral arteritis in order to confirm the diagnosis timely.