CAJ | 학술논문

目的：探讨成人乙型脑炎的 MRI表现及DWI早期特点,提高对其的认识。方法收集经临床确诊32例成人乙型脑炎患者资料,均常规T1 WI、T2 WI扫描、FLAIR 序列,28例行 DWI 检查。其中23例早期(1~7 d 内)均应用扩散加权像,分析 DWI、ADC图、T2 WI病灶信噪比,同时测感兴趣 ADC值。结果32例中 MRI阳性的28例,4例为阴性病例,22例累及丘脑,13例累及中脑黑质,9例累及海马,7例累及基底节,4例累及胼胝体压部,3例累及脑桥,2例累及岛叶,2例伴广泛大脑水肿。其中23例早期DWI显示：3例以细胞毒性水肿为主,12例以血管源性水肿为主,5例为2种水肿共同存在,3例阴性。DWI 优于 T2 WI 6例, T2 WI优于DWI 9例,DWI和T2 WI显示病灶大小、信号相仿5例。结论成人乙型脑炎好发于丘脑、中脑黑质和海马。急性期病灶以血管源性水肿为主,全面分析DWI、ADC图和T2 WI细节有助于成人乙型脑炎病灶早期检出及定性。
목적：탐토성인을형뇌염적 MRI표현급DWI조기특점,제고대기적인식。방법수집경림상학진32례성인을형뇌염환자자료,균상규T1 WI、T2 WI소묘、FLAIR 서렬,28례행 DWI 검사。기중23례조기(1~7 d 내)균응용확산가권상,분석 DWI、ADC도、T2 WI병조신조비,동시측감흥취 ADC치。결과32례중 MRI양성적28례,4례위음성병례,22례루급구뇌,13례루급중뇌흑질,9례루급해마,7례루급기저절,4례루급변지체압부,3례루급뇌교,2례루급도협,2례반엄범대뇌수종。기중23례조기DWI현시：3례이세포독성수종위주,12례이혈관원성수종위주,5례위2충수종공동존재,3례음성。DWI 우우 T2 WI 6례, T2 WI우우DWI 9례,DWI화T2 WI현시병조대소、신호상방5례。결론성인을형뇌염호발우구뇌、중뇌흑질화해마。급성기병조이혈관원성수종위주,전면분석DWI、ADC도화T2 WI세절유조우성인을형뇌염병조조기검출급정성。
Objective To study the conventional MRI features of adult Japanese encephalitis (JE)and explore the early features of diffusion weighted imaging(DWI).Methods Thirty-two patients with adult JE were included.MR scanning including T1 WI,T2 WI and FLAIR were done in all patients,and DWI in 28 patients.Twenty-three patients received DWI in the early stage (within 1 to 7 days),in which the appearances of DWI were analyzed,ADC graphs were obtained and the signal noise ratio and the ADC values of lesions were calculated.Results Twenty-eight cases were abnormal on MRI,and 4 patients were normal.The lesions of JE involved the thalamus in 22 cases,the substantia nigra of midbrain in 13,kellogg’s seahorse in 9,the basal ganglia in 7,the splenium corpo-ris callosi in 4,the pons in 6 and the insular lobe in 2,extensive cerebral edema in 2.The early features of DWI in 23 patients showed cytotoxic edema in 2,vasogenic edema in 12,both two edemas existing in 5,and normal in 3.DWI were superior to T2 WI in 6 cases,and T2 WI were superior to DWI in 9 cases,DWI was similar to T2 WI in 5 cases on showing the size and signal of the le-sions.Conclusion Adult JE often occurs in the thalamus,substantia nigra of midbrain and kellogg’s seahorse.DWI shows vasogenic edema in the early stage.Comprehensive analysis of DWI,ADC and T2 WI details helps to early detection and qualitative adult JE le-sions.