急性脑炎的MRI研究进展  

Research progress of acute encephalitis in MRI

作　　者：龚晓明 鲁植艳[1] GONG Xiao-ming;LU Zhi-yan(Department of radiology,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院影像科

出　　处：《新发传染病电子杂志》2019年第4期240-243,共4页Electronic Journal of Emerging Infectious Diseases

基　　金：北京市医院管理局重点医学专业发展计划(ZYLX201511);湖北省卫生健康委面上项目(WJ2017M044)

摘　　要：急性脑炎是由病毒、细菌、真菌或其他微生物引起的以中枢神经系统损害为主的传染病,该病可危及生命,若早期采取积极有效的治疗措施,可提高治愈率。临床上对于典型急性脑炎患者,可结合神经系统症状和感染体征进行诊断,而疑似患者往往诊断较难。影像学检查对于各类病原体引起的急性脑炎的诊断至关重要,尤其是在行腰椎穿刺后,立即进行颅脑MRI检查是诊断急性脑炎的首选方式。颅脑MRI检查可提示诊断,有时甚至可提示病原体;它不仅能评估脑损伤的程度,还能排除一些主要的鉴别诊断,如脑血管性病变或肿瘤。目前国内对各类病原体引起脑炎的MRI表现的综述较少,本文简要综述了部分病毒及细菌性脑炎的发病机制和不同病原体引起的脑炎的MRI表现,以利于早期准确诊断,指导临床进行及时有效的治疗。Acute encephalitis is an infectious disease caused by viruses, bacteria, fungi or other microorganisms, which will mainly cause by central nervous system damage. This disease can be life-threatening. If active and effective treatment measures can be taken earlier, the cure rate will be improved. In clinical practice, patients with typical acute encephalitis can be diagnosed by neurological symptoms and signs of infection, while suspected patients are often difficult to be diagnosed. Imaging examination is crucial for the diagnosis of acute encephalitisby various pathogens, especially after the lumbar puncture. Immediate MRI examination of the brain is the first choice for the diagnosis of acute encephalitis [1]. Brain MRI can prompt diagnosis and sometimes even can discover pathogens. It can not only assess the extent of brain damage, but also exclude some major differential diagnoses, such as cerebrovascular lesions or tumors[2]. At present, there are few reviews about MRI manifestations of encephalitis caused by various pathogens in China. This article briefly reviews the pathogenesis of some viruses and bacterial encephalitis and the MRI manifestations of encephalitis caused by different pathogens, in order to facilitate early accurate diagnosis and guide clinical practice timely and effectively.

关 键 词：急性脑炎 病原体 MRI 

分 类 号：R512.3[医药卫生—内科学] R445.2[医药卫生—临床医学]