儿童自身免疫性脑炎MRI特点  

MRI features of autoimmune encephalitis in children

作　　者：刘婧[1] 王可[1] 王霄英[1] 肖江喜[1] LIU Jing;WANG Ke;WANG Xiaoying;XIAO Jiangxi(Department of Radiology,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院医学影像科,北京100034

出　　处：《中国医学影像技术》2020年第11期1611-1614,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察儿童自身免疫性脑炎(AE)的头部MRI表现。方法回顾性分析16例临床确诊AE患儿的头部MRI表现,并进行MRI分型:1型,颅内无病变;2型,边缘叶型;3型,边缘叶外型;4型,混合型;2~4型均为异常表现。结果16例AE中,头部MRI诊断为1型8例,3、4型各4例,未见2型病例。8例3、4型AE中,5例主要累及额叶、颞叶、岛叶、顶叶及基底核、海马等,表现为点状或斑片状T2WI及T2液体衰减反转恢复(FLAIR)高信号、弥散加权成像(DWI)等信号;2例主要累及颞叶、额叶、顶叶、岛叶及海马,表现为点状或斑片状T2WI及T2 FLAIR高信号、DWI高信号,其中1例大脑皮层增厚;1例小脑萎缩。结论50%AE患儿存在脑部异常,主要累及是颞叶、额叶、岛叶及海马,MRI主要表现为T2WI、T2 FLAIR高信号。Objective To observe the head MRI features of autoimmune encephalitis(AE)in children.Methods The head MRI manifestations of 16 children with AE were retrospectively analyzed.MRI manifestations of AE were classified into 4 types:Type 1,normal;type 2,only hippocampal lesions;type 3,lesions not involving the hippocampus;type 4,lesions in both the hippocampus and other brain areas.Among the above types of AE,2-4 types were regarded as abnormal.Results Among 16 children with confirmed AE,type 1 of MRI was observed in 8 cases,while type 3 and 4 were detected each in 4 cases,respectively.No type 2 of MRI was found.Among 8 cases with type 3 and 4 MRI findings of AE,dot or patchy T2WI and T2 fluid attenuated inversion recovery(FLAIR)high signals with iso-intensity of diffusion weighted imaging(DWI)were noticed,mainly involving frontal lobe,temporal lobe,insular lobe,parietal lobe,basal nucleus and hippocampus in 5 cases,while in 2 cases,punctate or patchy T2WI and T2 FLAIR high signals with hyper-intensity of DWI mainly involving temporal lobe,frontal lobe,parietal lobe,insular lobe and hippocampus were observed,and cerebral cortex thickening was found in 1 of them.One case showed cerebellar atrophy.Conclusion Half proportion of children with AE had brain abnormalities mainly affected temporal lobe,frontal lobe and insular lobe and hippocampus.The main MRI manifestations included high signal intensities on T2WI and T2 FLAIR.

关 键 词：脑炎 神经系统自身免疫性疾病 磁共振成像 儿童 

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