抗VGKC脑炎患者的头颅磁共振表现

Brain magnetic resonance-imaging findings of anti-VGKC-complex encephalitis patients

目的:探讨抗电压门控钾离子通道(voltage-gated potassium channel,VGKC)脑炎患者的磁共振(MRI)特点及其与临床的关系。方法:对2011-10~2017-10的16例抗LGI1抗体阳性患者、4例抗Caspr2抗体阳性患者以及3例抗LGI1抗体阳性合并抗Caspr2抗体阳性患者的资料进行登记整理,采取回顾性分析研究患者MRI影像的成像表现。结果:31.3%的抗LGI1抗体阳性的患者、50%的抗Caspr2抗体阳性患者以及所有抗LGI1抗体阳性合并抗Caspr2抗体阳性的患者头部MRI正常,异常的MRI影像学显示枕叶T2高信号、岛颞叶T2高信号、额叶T2高信号、海马T2高信号、小脑脚T2高信号,MRI正常的患者和MRI异常的患者年龄上无统计学意义(P>0.05),磁共振表现与急性期临床特点,如精神行为异常(P>0.05)、癫痫(P>0.05)、记忆损害(P>0.05)、睡眠障碍(P>0.05)等均无统计学意义。结论:抗VGKC脑炎患者磁共振影像学表现缺乏特异性,以正常或轻微改变为主,与临床症状无明显关系。

Objective：The aim of this report was to assess routine clinical brain magnetic resonance imaging（MRI）and its relation to clinical characteristics.Methods：Sixteen patients with positive anti-LGI1 antibody,4 patients with anti-Caspr2 antibody and 3 patients with positive anti-LGI1 antibody and anti-Caspr2 antibody were consecutively registered during Oct.2011 and Oct.2017.Brain MRI findings were retrospectively analyzed.Results：An MRI of the brain was normal in 31.3% patients with positive anti-LGI1 antibodies,50% patient with positive anti-Caspr2 antibodies and all patients with positive anti-LGI1 antibody and anti-Caspr2 antibody.The initial MRI was abnormal with T2 signal hyperintensity in the occipital lobe,insula lobe,temporal lobe,frontal lobe,hippocampus or cerebellum foot.The ages of patients with normal and abnormal MRI findings had no statistically significant differences（P〈0.05）.There were no statistically significant differences between the MRI findings and clinical characteristics [mental abnormalities（P〈0.05）,seizure（P〈0.05）,memory impairment（P〈0.05）,and sleep disorder（P〈0.05） ].Conclusion：Brain MRI abnormalities of anti-VGKC-complex encephalitis are lack of specificity with normal or slight changes,and typically mild or unrelated to clinical symptoms.