摘要
目的 加深对病毒性脑炎CT、MRI表现的认识 ,以提高临床对该病变诊断的准确性。材料与方法 回顾分析 48例病毒性脑炎 (男 2 6例 ,女 2 2例 ,平均年龄 3 6岁 )的临床及影像学资料 ,其中单纯疱疹病毒 (HSV)脑炎 8例。经手术病理证实者 1例。检查方法 :CT检查 2 3例 ,MRI检查 14例 ,同时经CT和MRI检查者 11例。作CT和MRI增强检查者共 12例。结果 脑内有多发或单发病灶者 47例 ,主要位于皮层、皮层下及侧脑室周围白质 ,以及基底节 丘脑区 ,CT上呈低密度 ,MRI上呈长T1长T2 信号 (同时经两种方法检查的病例中 ,5例CT未显示病灶 ,但MRI均发现病灶 )。HSV脑炎中 ,7例发现病灶位于颞叶、额下区、脑岛及扣带回。 1例伴小脑受累 ,1例伴病灶内出血 ,无异常改变者 1例。增强扫描病例中显示病灶强化者 3例。结论 CT、MRI能为病毒性脑炎的临床诊断提供重要诊断信息 ,且MRI优于CT。与有相似影像表现病变的鉴别应紧密结合临床资料 ,仅凭CT、MRI表现有一定局限性。
Objective To make a further understanding of the manifestations of viral encephalitis on CT and MR images, and to improve its diagnostic accuracy.Materials and Methods The clinical and imaging data in 48 cases with viral encephalitis (26 male, 22 female, mean age 36 years) were analyzed retrospectively. The diagnosis was clinically and experimentally made in 47 cases, and was surgically and pathologically confirmed in one case. CT was performed in 23 cases, MRI in 14 cases, both CT and MRI in 11 cases, and enhanced CT or MR in 12 cases.Results Abnormalities were found in 47 cases, including multiple or single lesions located mainly in cortices, subcortical and periventricular white matter, basal ganglia and thalami. The lesions presented as low density on CT scan, and carried long T 1 and long T 2 on MRI. Of 11 cases underwent both CT and MRI, 5 showed normal on CT but demonstrated lesions on MRI. In 7 cases with HSV encephalitis, lesions were seen in temporal lobe, sub frontal lobe, insulate and the cingulate gyrus. Cerebellum was involved in 1 case. Hemorrhage was present in 1 case. One case appeared normal.Conclusion CT and MRI can provide important information for clinical diagnosis of viral encephalitis. MRI is superior to CT. Differential diagnosis from other diseases with similar CT and MRI findings should be based on clinical data.
出处
《临床放射学杂志》
CSCD
北大核心
2000年第3期133-136,共4页
Journal of Clinical Radiology
