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中华脑科疾病与康复杂志(电子版) ›› 2021, Vol. 11 ›› Issue (02) : 105 -108. doi: 10.3877/cma.j.issn.2095-123X.2021.02.009

短篇论著

抗NMDAR脑炎的头颅MRI影像特征分析
姚东陂1, 刘鹏1, 朱吉强1, 张建林1, 郑雪燕1, 孙千贺1, 王红欣2,()   
  1. 1. 100122 北京朝阳中西医结合急诊抢救中心神经内二科
    2. 100122 北京,北京朝阳急诊抢救中心放射科
  • 收稿日期:2020-03-06 出版日期:2021-04-15
  • 通信作者: 王红欣

Analysis of head MRI imaging features of anti-NMDAR encephalitis

Dongpo Yao1, Peng Liu1, Jiqiang Zhu1, Jianlin Zhang1, Xueyan Zheng1, Qianhe Sun1, Hongxin Wang2,()   

  1. 1. Department of Neurology, Beijing Chaoyang Integrative Medicine Emergency Medical Center, Beijing 100122, China
    2. Department of Radiology, Beijing Chaoyang Emergency Medical Center, Beijing 100122, China
  • Received:2020-03-06 Published:2021-04-15
  • Corresponding author: Hongxin Wang
引用本文:

姚东陂, 刘鹏, 朱吉强, 张建林, 郑雪燕, 孙千贺, 王红欣. 抗NMDAR脑炎的头颅MRI影像特征分析[J/OL]. 中华脑科疾病与康复杂志(电子版), 2021, 11(02): 105-108.

Dongpo Yao, Peng Liu, Jiqiang Zhu, Jianlin Zhang, Xueyan Zheng, Qianhe Sun, Hongxin Wang. Analysis of head MRI imaging features of anti-NMDAR encephalitis[J/OL]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2021, 11(02): 105-108.

目的

探讨抗N-甲基-D-天冬氨酸受体(NMDAR)脑炎的头颅MRI影像特征。

方法

回顾性分析自2018年12月至2020年6月于北京朝阳中西医结合急诊抢救中心神经内二科诊治的12例抗NMDAR脑炎患者的一般资料及头颅MRI影像结果。

结果

12例患者头颅MRI影像结果:正常者4例(33.3%),异常者8例(66.7%);病灶呈单发或多发,片状或斑片状,边界模糊。病变部位:颞叶内侧6例(75.0%)、岛叶4例(50.0%)、额叶3例(37.5%)。异常序列:T1WI低信号者2例(25.0%)、T2WI高信号者6例(75.0%)、FLAIR高信号者8例(100%)、DWI高信号者3例(37.5%);有强化者3例(37.5%),具体表现为病变区点状、片絮状强化,部分软脑膜及邻近血管强化。

结论

头颅MRI影像表现虽不能作为诊断抗NMDAR脑炎的特异性指标,但对病变出现在颞叶内侧和(或)岛叶部位、呈片状或斑片状、边界模糊、FLAIR和(或)T2WI高信号、部分有强化时,应高度警惕抗NMDAR脑炎的可能。

Objective

To explore the characteristics of head MRI of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis.

Methods

The general data and head MRI results of 12 patients with anti-NMDAR encephalitis who were diagnosed and treated in the Neurology Department of Beijing Chaoyang Integrative Medicine Emergency Medical Center from December 2018 to June 2020 were collected and retrospectively analyzed.

Results

Head MRI results of the 12 patients: normal in 4 cases (33.3%), abnormal in 8 cases (66.7%), the lesions were single or multiple, flaky or patchy, with blurred borders. Lesion location: medial temporal lobe 6 cases (75.0%), insular lobe 4 cases (50.0%), frontal lobe 3 cases (37.5%). Abnormal sequence: 2 cases (25.0%) with low signal on T1WI, 6 cases (75.0%) with high signal on T2WI, 8 cases (100%) with high signal on FLAIR, and 3 cases (37.5%) with high signal on DWI. There were 3 cases (37.5%) with enhancement, the specific manifestations were punctate and flocculent enhancement in the lesion area, part of the pia mater and adjacent blood vessels.

Conclusion

Although head MRI imaging can not be used as a specific indicator for the diagnosis of anti-NMDAR encephalitis, the possibility of anti NMDAR encephalitis should be highly vigilant when the lesions appear in the medial temporal lobe and (or) the insular lobe, are flaky or patchy, with blurred borders, high signal intensity on FLAIR and (or) T2WI and partial enhancement.

表1 12例抗N-甲基-D-天冬氨酸受体脑炎患者的临床资料
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