摘要
目的探讨自身免疫性脑炎(AE)不同亚型的临床特点及MRI影像特征,为临床医师及时诊治提供依据。方法纳入AE患者66例,收集临床一般资料、相关抗体检测及观察MRI表现,分析其主要临床特征与影像学表现。结果66例AE患者中男性30例,女性36例(男:女=1:1.2),平均发病年龄约40.14岁。主要症状为认知功能障碍34例(51.5%),精神行为异常24例(36.4%)和癫痫23例(34.8%)。脑脊液抗体阳性率较血清抗体阳性率高。MRI图像各亚型AE均可见脑实质受累,可同时累及多个脑区,依次为海马及颞叶内侧、额顶枕叶、基底节区、丘脑脑干及小脑等,T1WI呈等或稍低信号,T2WI/FLAIR呈高信号,其中20例行增强扫描,11例有强化效应,呈点线样、斑片状轻-中度强化,软脑膜及脑沟血管可见强化。结论MRI表现虽不能作为诊断AE的特异性指标,但是对于常规MRI检查出现异常信号,尤其在好发部位的,应高度怀疑AE的可能性,其中FLAIR为最佳序列。
Objective Exploring the clinical and MRI features of different subtypes of autoimmune encephalitis(AE)to provide a basis for clinicians′timely diagnosis and treatment.Methods A total of 66 patients with AE were included.General clinical data,related antibody detection and MRI performance were collected,and their main clinical features and imaging findings were analyzed.Results Among 66 AE patients,there were 30 males and 36 females(male:female=1:1.2),with an average age of onset of about 40.14 years.The main symptoms were cognitive dysfunction in 34 cases(51.5%),mental and behavioral abnormalities in 24 cases(36.4%)and epilepsy in 23 cases(34.8%).The positive rate of CSF antibody was higher than that of serum antibody.MRI images of all subtypes of AE can show brain involvement,which can involve multiple brain regions at the same time,followed by hippocampus and medial temporal lobe,frontal parietal and occipital lobe,basal ganglia and thalamus,brainstem and cerebellum.T1WI showed equal or slightly lower signal,T2WI/FLAIR showed high signal,a total of 20 routine enhancement scan,11 cases have enhancement effect,showing dot-line,patchy light-to-moderate enhancement,visible enhancement of pia mater and sulcus blood vessels.Conclusion Although MRI performance cannot be used as a specific indicator for diagnosis of AE,but for abnormal signals in routine MRI examination,especially in the prone area,the possibility of AE should be highly suspected,and FLAIR is the best sequence.
作者
孙颖志
张杰
冯秀龙
崔武勋
崔光彬
SUN Ying-zhi;ZHANG Jie;FENG Xiu-long;CUI Wu-xun;CUI Guang-bin(Department of Radiology Tangdu Hospital,Air Force Medical University,Department of Radiology&Functional and Molecular Imaging Key Lab of Shaanxi Province,Xi′an 710038,China)
出处
《延安大学学报（医学科学版）》
2020年第4期68-73,共6页
Journal of Yan'an University:Medical Science Edition
基金
国家重点研发项目(2016YFC0107105)。
关键词
自身免疫性脑炎
临床表现
MRI
Autoimmune encephalitis
Clinical manifestations
MRI
作者简介
孙颖志(1981-),男,安徽淮南人,硕士,主治医师。研究方向:神经影像;通信作者:崔光彬(1967-),男,黑龙江佳木斯人,博士,主任医师。研究方向:神经影像学及胸、腹部疾病分子影像学病理基础。E-mail:cgbtd@126.com。
