病毒性脑炎的病理基础与MRI诊断

目的 探讨病毒性脑炎MRI表现特点及其与病理变化的相关性,深化对病毒性脑炎影像表现的认识.方法 回顾性分析17例经临床证实的病毒性脑炎患者MRI影像表现与病毒性脑炎病理表现的相关性.17例均行MRI平扫及FLAIR扫描,其中13例行增强扫描.结果 病毒性脑炎病灶主要位于大脑皮层灰质及大脑皮层下灰质核团.16例为多发病灶,1例为单发.病灶边缘清晰,周边无明显水肿.平扫T_1WI呈稍低或等信号,T_2WI呈稍高信号,FLAIR序列呈明显高信号.增强后病变表现多样,2例无明显强化,15例表现为脑表面线样强化,其中6例伴脑实质病变内淡薄斑片状强化,2例呈脑回状强化.结论 MRI能够反映病毒性脑炎的病理表现,对鉴别诊断很有价值.

The Pathological Foundation and MRI Diagnosis of Virus Encephalitis

Objective To explore MRI characteristics of virus encephalitis and its relevance with pathlological changes,and to improve understanding MRI features of virus encephalitis.Methods Seventeen cases of virus encephalitis clinically proven were collected and reviewed.The correlation between MRI findigns and pathology were analyzed.MRI examinations included plain scan and FLAIR scan in all 17 patients,among which 13 underwent contrast-enhanced MR scanning.Results The lesions mainly located at the cerebral cortex gray matter and the cerebrum subcortical gray matter nuclei.16 cases appeared as multiple foci,and 1 case was single focus.The foci had definite margins and with no obvious peripheral edema.The lesions were slightly hypo-or iso-intense on T_1WI,slightly intensity on T_2WI and obvious high signal intensity on FLAIR.After enhanced scan,the lesions were no obvious enhancement in 2 cases,enhancement line in the surfaces of the brain in 15 cases,in which the lesions showed patch enhancement in 6 cases and gyrus-like enhancement in 2 cases.Conclusion The pathological changes of viral encephalitis can be reflexed with MR imaging features,which is of important value in the differential diagnosis of virus encephalitis.