病毒性脑炎的CT、MRI诊断附48例报告.pdfVIP

临床放射学杂志000302 临床放射学杂志 JOURNAL OF CLINICAL RADIOLOGY 2000　Vol.19　No.3　P.133-136 病毒性脑炎的CT、MRI诊断(附48例报告) 罗敏　肖家和 摘　要：目的　加深对病毒性脑炎CT、MRI表现的认识，以提高临床对该病变诊断的准 确性。　材料与方法　回顾分析48例病毒性脑炎(男26例，女22例，平均年龄36岁)的临床 及影像学资料，其中单纯疱疹病毒(HSV)脑炎8例。经手术病理证实者1例。检查方法： CT检查23例，MRI检查14例，同时经CT和MRI检查者11例。作CT和MRI增强检查者共12 例。　结果　脑内有多发或单发病灶者47例，主要位于皮层、皮层下及侧脑室周围白 质，以及基底节-丘脑区，CT上呈低密度，MRI上呈长T 长T 信号(同时经两种方法检查 1 2 的病例中，5例CT未显示病灶，但MRI均发现病灶)。HSV脑炎中，7例发现病灶位于颞 叶、额下区、脑岛及扣带回。1例伴小脑受累，1例伴病灶内出血，无异常改变者1例。增 强扫描病例中显示病灶强化者3例。　结论　CT、MRI能为病毒性脑炎的临床诊断提供重 要诊断信息，且MRI优于CT。与有相似影像表现病变的鉴别应紧密结合临床资料，仅凭 CT、MRI表现有一定局限性。 关键词：病毒性脑炎　体层摄影术，X线计算机　磁共振成像 CT and MRI Diagnosis of Viral EncephalitisA Report of 48 Cases LUO Min　XIAO Jiahe （Department of Radiology, No.1 Affiliated Hospital, West China Medical University, Chengdu, Sichuan Province 610041, P.R.China ） ABSTRACT ：Objective　To make a further understanding of the manifestations of viral encephalitis on CT and MR images, and to improve its diagnostic accuracy.Materials and Methods　The clinical and imaging data in 48 cases with viral encephalitis (26 male, 22 female, mean age 36 years) were analyzed retrospectively. The diagnosis was clinically and experimentally made in 47 cases, and was surgically and pathologically confirmed in one case. CT was performed in 23 cases, MRI in 14 cases, both CT and MRI in 11 cases, and enhanced CT or MR in 12 cases.　Results Abnormalities were found in 47 cases, including multiple or single lesions located mainly in cortices, subcortical and periventricular white matter, basal ganglia and thalami. The lesions presented as low density on CT scan, and carried long T1 and long T2 on MRI. Of 11 cases underwent both CT and MRI, 5 showed normal