CAJ | 학술논문

目的探讨病毒性脑炎患者的MRI及1H-MRS表现特点及临床意义,以提高诊断准确率.方法回顾性分析22例病毒性脑炎患者的MRI临床及影像学资料.22例均经MRI检查,其中9例行MRI及1H-MRS分析.结果病毒性脑炎脑内有多发或单发对称或不对称病灶,主要位于皮层、皮层下及基底节-丘脑区,1例显示一侧小脑半球受累.MRI呈长T1、长T2信号,T2-flair序列能更清楚显示病变.9例增强扫描中6例显示斑片状、脑回状强化.9例行1 H-MRS波谱分析,选取18个体素分两组,每组9个,一组置于病灶区,一组置于同一患者MRI表现正常区.病灶区:NAA峰下降6例,Cho和Cho/Cr升高7例,ml和Mi/Cr升高7例,出现Lac峰5例,以上是与MRI表现正常的正常人的1 H-MRS比较.其中有3例MRI表现正常区体素也显示波谱异常:NAA/Cr下降,Cho/Cr升高.结论常规MRI表现及1H-MRS新技术能为病毒性脑炎的临床诊断提供重要诊断信息,在紧密结合临床资料的同时,MRI可在一定程度上为临床的早期诊断、治疗监测及评估预后提供依据.
목적 탐토병독성뇌염환자적MRI급1H-MRS표현특점급림상의의,이제고진단준학솔.방법 회고성분석22례병독성뇌염환자적MRI림상급영상학자료.22례균경MRI검사,기중9례행MRI급1H-MRS분석.결과 병독성뇌염뇌내유다발혹단발대칭혹불대칭병조,주요위우피층、피층하급기저절-구뇌구,1례현시일측소뇌반구수루.MRI정장T1、장T2신호,T2-flair서렬능경청초현시병변.9례증강소묘중6례현시반편상、뇌회상강화.9례행1 H-MRS파보분석,선취18개체소분량조,매조9개,일조치우병조구,일조치우동일환자MRI표현정상구.병조구:NAA봉하강6례,Cho화Cho/Cr승고7례,ml화Mi/Cr승고7례,출현Lac봉5례,이상시여MRI표현정상적정상인적1 H-MRS비교.기중유3례MRI표현정상구체소야현시파보이상:NAA/Cr하강,Cho/Cr승고.결론 상규MRI표현급1H-MRS신기술능위병독성뇌염적림상진단제공중요진단신식,재긴밀결합림상자료적동시,MRI가재일정정도상위림상적조기진단、치료감측급평고예후제공의거.
Objective To investigate the MRI and 1H-MRS features of viral encephalitis and its clinical significance,in order to improve the diagnostic accuracy rate.Methods The MRI clinical and imaging data of 22 cases of viral encephalitis were retrospectively analyzed.The 22 cases were examined by MRI,9 cases underwent MRI and 1 H-MRS analysis.Results Viral encephalitis had single or multiple symmetrical or asymmetrical lesions,mainly located in the cortex,subcortical and basal ganglia and thalamus,1 case showed that one side of the cerebellum was involved.MRI showed long T1,long T2 signal,T2-flair sequence can clearly display the lesions.Nine cases had enhanced scan,of which 6 cases showed patchy,gyros-like enhancement.Nine patients underwent 1H-MRS pop analysis,18 vowel were selected and divided into two groups,with 9 vowel in each group,one group located in the lesion,and one group located in the MRI normal region of the same patients.Focus:peak NAA decreased in 6 cases,Cho and Cho/Cr increased in 7 cases,mI and Mi/Cr increased in 7 cases,Lac peak occured in 5 cases,the above was compared with the normal MRI 1 H-MRS of normal people.There were 3 MRI manifestations of the normal zone voxels also showed pop exception:NAA/Cr decreased,Cho/Cr increased.Conclusions Conventional MRI and 1H-MRS new technology can provide important diagnostic information for clinical diagnosis of viral encephalitis,at the same time of close connection with the clinical data,MRI can provide the basis for early diagnosis,treatment and evaluation of prognosis in a certain extent.