CT灌注成像辅助诊断单纯疱疹病毒1型脑炎一例  

CTP imaging assisted diagnosis of herpes simplex virus type one encephalitis:a case report

作　　者：符雄琳 龙发青[1] Fu Xionglin;Long Faqing(Department of Neurology,the Second Affiliated Hospital of Hainan Medical College,Haikou 570216,China)

机构地区：[1]海南医学院第二附属医院神经内科,海口570216

出　　处：《新医学》2023年第3期226-230,共5页Journal of New Medicine

摘　　要：单纯疱疹病毒性脑炎又称急性坏死性脑炎,是由疱疹病毒感染引起的脑实质炎症。CT灌注成像(CTP)可快速显示脑部组织灌注异常及脑组织受损情况,常被用于脑卒中的诊断,而被用于辅助诊断脑炎的文献报道较少。该文报道了1例通过CTP辅助诊断单纯疱疹病毒1型脑炎的59岁男性患者。该例患者起病急,突发右侧肢体抽搐伴发热,且伴有精神症状,不能配合完成MRI,故急行头颅CTP,结果显示其左侧颞叶灌注较右侧增加,不排除病毒性脑炎的诊断,遂于入院12 h内泵注阿昔洛韦抗病毒治疗及予其他对症治疗,患者病情逐渐好转。入院后3 d脑脊液病原体二代测序结果回报,明确诊断为单纯疱疹病毒1型脑炎。Herpes simplex virus encephalitis(HSE),also known as acute necrotizing encephalitis,is an inflammation of brain parenchyma caused by herpes virus infection.CT perfusion(CTP)imaging,can quickly display abnormal brain tissue perfusion and brain tissue damage,which is commonly used for the diagnosis of stroke.Use of CTP in the auxiliary diagnosis of encephalitis has been rarely reported.Here,a 59-year-old male case of HSE-1 encephalitis diagnosed by CTP was reported.The patient had acute onset of right limb twitching complicated with fever,and mental symptoms.He failed to cooperate with MRI.Therefore,CTP was performed urgently.The results showed that the perfusion of the left temporal lobe was higher than that of the right side.The diagnosis of viral encephalitis could not be excluded.Therefore,acyclovir was pumped for antiviral therapy and other symptomatic treatment was delivered within 12 h after admission,and the conditions were gradually improved.At 3 d after admission,the diagnosis of HSE-1 encephalitis was confirmed by the next-generation sequencing of cerebrospinal fluid pathogens.

关 键 词：单纯疱疹病毒性脑炎 单纯疱疹病毒1型 CT灌注成像 

分 类 号：R512.3[医药卫生—内科学]