老年流行性乙型脑炎的临床及影像特点分析  

Analysis of clinical and radiological features of elderly patients with epidemic encephalitis B

作　　者：宋海乔[1] 强军[1] 许晓亮[1] SONG Haiqiao;QIANG Jun;XU Xiaoliang(Department of Imaging,First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,China)

机构地区：[1]河南科技大学第一附属医院影像科,河南洛阳471003

出　　处：《中国中西医结合影像学杂志》2021年第2期124-127,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的:分析老年流行性乙型脑炎(乙脑)的临床及影像特点。方法:回顾性分析19例老年乙脑患者的临床及影像资料,其中18例行MRI平扫及DWI检查,1例行CT检查。结果:19例均发热,13例意识障碍,6例抽搐,17例伴高血压和既往脑卒中病灶。17例MRI阳性表现患者中,12例累及丘脑(单/双侧),7例累及中脑黑质或脑桥(单/双侧),5例累及海马(双侧),2例累及基底节(双侧),1例累及侧脑室体旁(单侧),1例累及岛叶(单侧),1例大脑半球广泛水肿,多数病例表现为多部位被累及;病灶在急性期多表现为血管源性水肿,DWI多呈等或稍高信号。17例在发现乙脑病灶同时亦显示既往陈旧脑卒中病灶。结论:老年乙脑具有较典型临床及影像特点,好发于丘脑、中脑黑质及海马,多伴既往脑卒中病灶,部分病灶与陈旧性梗死灶可有混淆,全面分析MRI常规序列和DWI表现有助于其鉴别。Objective:To analyze the clinical and MRI features of elderly patients with epidemic encephalitis B.Methods:Retrospective analysis of the clinical and imaging data of 19 elderly patients with epidemic encephalitis B,MRI plain scan and DWI were performed in 18 cases in the acute phase,and CT were performed in 1 case in the absorption phase of cerebral hemorrhage.Results:There were fever in 19 cases,consciousness disorder in 13 cases,convulsion in 6 cases,hypertension and previous stroke in 17 cases.Imaging manifestations of 17 cases with MRI disorder showed that 12 cases involved thalamus(single or bilateral),7 cases involved substantia nigra(single or bilateral),5 cases involved hippocampus(bilateral),2 cases involved basal ganglia(bilateral),1 case involved paraventricular(single),1 case involved insula(single),1 case involved cerebral hemisphere(bilateral).In most cases,multiple sites were involved.Most of the lesions were angiogenic edema in the acute phase,and DWI was isointense or slightly hyperintense.In 17 cases,the focus of epidemic encephalitis B was found and the focus of old stroke was also found.Conclusions:Epidemic encephalitis B in the elderly has typical clinical and imaging features,and epidemic encephalitis B is easy to involve thalamus,substantia nigra and hippocampus.Most of them are accompanied by previous stroke lesions.Some lesions may be confused with old infarcts.A comprehensive analysis of conventional sequences and DWI is helpful to distinguish them.

关 键 词：脑炎 日本 老年人 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R512.32[医药卫生—诊断学]