Rasmussen脑炎的MRI诊断  

MRI diagnosis of Rasmussen encephalitis

作　　者：赵殿江[1] 朱明旺[1] 杜铁桥[1] 王丽宁[1] 张旭妃[1] 

机构地区：[1]首都医科大学第十一临床医学院北京三博脑科医院影像科,100093

出　　处：《中华放射学杂志》2012年第4期308-311,共4页Chinese Journal of Radiology

基　　金：基金项目：首都临床特色应用研究项目（Z111107058811094）

摘　　要：目的总结Rasmussen脑炎的MRI特点，提高对本病影像表现的认识。方法回顾性分析10例Rasmussen脑炎患者的MR图像，男7例、女3例，平均年龄（11±4）岁。常规行横断面、矢状面及垂直于海马长轴的斜冠状面扫描，获得T1WI、T2WI及液体衰减反转恢复（FLAIR）序列图像。评估Rasmussen脑炎患者术前MR检查中脑萎缩和信号情况，以及上述改变在随访时MR的表现。结果Rasmussen脑炎的影像特点为：（1）脑萎缩性改变：患侧侧脑室体部扩大（8／10），颞角扩大（9／10），外侧裂增宽（9／10），局部脑沟增宽和脑回变小（7／10），尾状核和壳核萎缩（6／10）。病变晚期皮层萎缩多为半球性或累及2个以上脑叶。（2）信号改变：皮层或皮层下长T2信号（9／10），多累及2个以上脑叶。（3）病变进展性：8例接受随访MR的患者均可见病变侧半球的萎缩性改变加重，范围加大，由局部向半球性发展；皮层信号改变较大。结论Rasmussen脑炎好发于儿童，表现为一侧大脑半球进展性萎缩改变，脑室扩大，外侧裂和脑沟增宽，脑回变小，伴有相应部位的皮层萎缩和皮层T2高信号，深部灰质核团也可受累。Objective To describe the MR features of Rasmussen encephalitis （RE）. Methods The MRI of 10 pathologic confirmed patients （7 male, 3 female, mean age 11 ± 4 years） with RE were retrospectively analyzed in this study. Routine axial, sagittal and coronal （perpendicular to the oblique long axis of the hippocampus） scans were obtained for T1WI, T2WI and fluid-attenuated inversion recovery （FLAIR） images. The location and degree of cerebral atrophy, gray matter signal changes, and the evolution of these findings were evaluated. Results Brain atrophy included the enlargement of lateral ventricle（8/10）, temporal horn（9/10）and lateral fissure（9/10） ; widened sulci and small gyri in the isolateral hemisphere （7/10） ; atrophy in caudate and putamen nucleus （6/10）. The cortical atrophy was extensive at late stage of the RE, and usually was hemispheric or involved more than two lobes. The signal changes included hyperintensity involving extensive cortical and/or subcortical regions （9/10）. The follow-up MR study demonstrated the progression of brain atrophy and extensive signal changes. Conclusions RE usually presents in pediatric patients. The imaging findings included progressive unilateral brain atrophy, enlargement of lateral ventricle, lateral fissure and sulci, and small gyri with or without cortical T2 hyperintensity. Deep nucleus atrophy may be involved in RE.

关 键 词：脑炎 癫痫 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]