DWI在散发性脑炎与急性脑梗死鉴别诊断价值  

Application of MR Diffusion Weighted Imaging in the DifferentialDiagnosis Between Encephalitis and Acute Cerebral Infarction

作　　者：黄仲奎[1] 邓德茂[1] 龙莉玲[1] 秦宇红[1] 

机构地区：[1]广西医科大学第一附属医院放射科,广西南宁530021

出　　处：《实用放射学杂志》2005年第2期120-122,共3页Journal of Practical Radiology

基　　金：广西自然科学基金资助项目(桂科基 0144013)。

摘　　要：　　目的　探讨磁共振弥散加权成像在散发性脑炎与急性脑梗死的鉴别诊断中的应用价值。方法　回顾性分析 23例经临床诊断的散发性脑炎,包括 14例病毒性脑炎和 9例脱髓鞘性脑炎的磁共振弥散加权表现,并与 30例急性脑梗死进行比较。结果　病毒性脑炎和脱髓鞘性脑炎病灶表现局灶性或大片异常信号,T1WI呈稍低信号,T2WI及FLAIR呈高信号。除 1例超急性脑梗死未能显示梗死灶外, 29例脑梗死病灶T1WI呈稍低信号,T2WI及FLAIR呈高信号。脑炎与梗死病灶在DWI均呈稍高或高信号。ADC值测量, 30例梗死灶ADC值为(0. 46±0. 13)×10-3 mm2 /s。7例病毒性脑炎和 9例脱髓鞘性脑炎ADC值分别为(0. 98±0. 18)×10-3 mm2 /s和(0. 89±0. 07)×10-3 mm2 /s,病毒性脑炎与脱髓鞘性脑炎病灶ADC值差异无统计学意义 (Ρ>0. 05),但明显高于脑梗死(Ρ<0. 01)和镜面对侧正常区(Ρ<0. 05)。有 4例病毒性脑炎病灶在不同区域弥散增加和受限并存,ADC值表现高低不一,最高者达 0. 96×10-3 mm2 /s,最低者达 0. 31×10-3 mm2 /s;另有 3例全部病灶ADC值表现降低,分别为 0. 44×10-3 mm2 /s、0. 51×10-3 mm2 /s和 0. 58×10-3 mm2 /s。结论　磁共振弥散加权成像对脑炎与急性脑梗死鉴别诊断具有重要临床价值。Objective To explore the diagnostic value of MR diffusion weighted imaging (DWI) in the differential diagnosis between encephalitis and acute cerebral infarction.Methods The MR DWI appearances of 23 cases of encephalitis including 14 cases with viral encephalitis, 9 cases with demyelinative encephalitis and 30 cases with acute cerebral infarction were retrospectively analyzed.Results The 30 cases of acute cerebral infarction appeared bright signal in DWI with a ADC values of (0.46±0.13)×10 -3mm2/s. 7 cases with viral encephalitis and 9 cases with demyelinative encephalitis appeared slightly high or high signal intensity in DWI with a ADC values of (0. 98±0.18)×10 -3mm2/s and(0. 89±0.07)×10 -3mm2/s respectively. The ADC values of viral encephalitis and demyelinative encephalitis were higher comparing to acute cerebral infarction(Ρ<0.01)and normal parenchyma(Ρ<0.05).But there was no significant difference between viral encephalitis and demyelinative encephalitis(Ρ>0.05). However, the ADC values showed higher or lower in different areas in 4 cases, and lower ADC values appearing in 3 cases with viral encephalitis comparing normal parenchyma.Conclusion MR DWI is useful in the differential diagnosis between encephalitis and acute cerebral infarction.

关 键 词：弥散 病毒性脑炎 脱髓鞘性脑炎 急性脑梗死 表面弥散系数值 

分 类 号：R512.3[医药卫生—内科学] R743.33[医药卫生—临床医学]