摘要
目的探讨抗N-甲基-D-天冬氨酸受体(NMDAR)脑炎的头颅MRI影像特征。方法回顾性分析自2018年12月至2020年6月于北京朝阳中西医结合急诊抢救中心神经内二科诊治的12例抗NMDAR脑炎患者的一般资料及头颅MRI影像结果。结果12例患者头颅MRI影像结果:正常者4例(33.3%),异常者8例(66.7%);病灶呈单发或多发,片状或斑片状,边界模糊。病变部位:颞叶内侧6例(75.0%)、岛叶4例(50.0%)、额叶3例(37.5%)。异常序列:T1WI低信号者2例(25.0%)、T2WI高信号者6例(75.0%)、FLAIR高信号者8例(100%)、DWI高信号者3例(37.5%);有强化者3例(37.5%),具体表现为病变区点状、片絮状强化,部分软脑膜及邻近血管强化。结论头颅MRI影像表现虽不能作为诊断抗NMDAR脑炎的特异性指标,但对病变出现在颞叶内侧和(或)岛叶部位、呈片状或斑片状、边界模糊、FLAIR和(或)T2WI高信号、部分有强化时,应高度警惕抗NMDAR脑炎的可能。
Objective To explore the characteristics of head MRI of anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis.Methods The general data and head MRI results of 12 patients with anti-NMDAR encephalitis who were diagnosed and treated in the Neurology Department of Beijing Chaoyang Integrative Medicine Emergency Medical Center from December 2018 to June 2020 were collected and retrospectively analyzed.Results Head MRI results of the 12 patients:normal in 4 cases(33.3%),abnormal in 8 cases(66.7%),the lesions were single or multiple,flaky or patchy,with blurred borders.Lesion location:medial temporal lobe 6 cases(75.0%),insular lobe 4 cases(50.0%),frontal lobe 3 cases(37.5%).Abnormal sequence:2 cases(25.0%)with low signal on T1WI,6 cases(75.0%)with high signal on T2WI,8 cases(100%)with high signal on FLAIR,and 3 cases(37.5%)with high signal on DWI.There were 3 cases(37.5%)with enhancement,the specific manifestations were punctate and flocculent enhancement in the lesion area,part of the pia mater and adjacent blood vessels.Conclusion Although head MRI imaging can not be used as a specific indicator for the diagnosis of anti-NMDAR encephalitis,the possibility of anti NMDAR encephalitis should be highly vigilant when the lesions appear in the medial temporal lobe and(or)the insular lobe,are flaky or patchy,with blurred borders,high signal intensity on FLAIR and(or)T2WI and partial enhancement.
作者
姚东陂
刘鹏
朱吉强
张建林
郑雪燕
孙千贺
王红欣
Yao Dongpo;Liu Peng;Zhu Jiqiang;Zhang Jianlin;Zheng Xueyan;Sun Qianhe;Wang Hongxin(Department of Neurology,Beijing Chaoyang Integrative Medicine Emergency Medical Center,Beijing 100122,China;Department of Radiology,Beijing Chaoyang Emergency Medical Center,Beijing 100122,China)
出处
《中华脑科疾病与康复杂志（电子版）》
2021年第2期105-108,共4页
Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）
