副肿瘤性边缘叶脑炎的临床及MRI表现  

Clinical and MR features of paraneoplastic limbic encephalitis

作　　者：周军 单凯 张秀富 

机构地区：[1]重庆市江津区中心医院放射科,重庆402260

出　　处：《影像诊断与介入放射学》2015年第3期204-207,共4页Diagnostic Imaging & Interventional Radiology

摘　　要：目的探讨副肿瘤性边缘叶脑炎(PLE)的临床及MRI表现。方法回顾性分析9例经临床诊断治疗的PLE的临床及MRI资料。结果 MRI信号特点:9例病变分布均以海马及海马旁回为主,其中4例同时累及双侧杏仁核,3例累及双侧颞叶及扣带回,2例累及岛叶。所有病灶FLAIR均呈高信号,其中7例T1WI呈较均匀稍低信号,T2WI呈高信号,DWI呈稍高或等信号;2例T1WI呈等信号,T2WI呈稍高信号,DWI呈等信号;6例增强检查,均无强化。脑脊液及血清学检查:5例脑脊液白细胞、淋巴细胞轻度升高,4例神经元细胞内抗体抗HU抗体阳性。结论 PLE具有较典型的临床及MRI特征,结合抗体检测及其他全身检查,一般能做出正确诊断。Objective To investigate the clinical and MR features of paraneoplastic limbic encephalitis（PLE）. Methods The clinical records and MRI of 9 patients with clinically diagnosed PLE were retrospectively analyzed. Results All lesions were located mainly in the hippocampus and parahippocampal gyrus with additional involvement of the bilateral amygdalas（4）, cingulate gyrus（3）, and insula（2）. All lesions were hyperintense on T2-FLAIR; 7 were hypointense on T1 WI and hyperintense on T2 WI and DWI; 2 were T1-isointense, T2-hyperintense and isointense on DWI. There was no contrast enhancement of lesions in 6 patients who underwent contrast-enhanced MRI. Lymphocytes were mildly elevated in the cerebrospinal fluid of 5 patients and anti-HU antibodies were present in 4. Conclusion PLE has typical clinical and MRI characteristics that can aid diagnosis in combination with antibody testing.

关 键 词：边缘叶脑炎 副肿瘤综合征 临床特征 磁共振成像 

分 类 号：R730.5[医药卫生—肿瘤]