【摘要】 目的探讨成人乙型脑炎的临床和影像学特点。方法回顾性分析30例成人乙型脑炎患者的临床资料。结果成人乙型脑炎以老年人居多。30例患者起病时均存在高热,意识障碍22例,急性肢体瘫痪4例,头痛6例,恶心、呕吐4例,头晕2例,反应迟钝2例,言语不清1例,癫痫1例。22例行头颅MRI检查,17例异常(77. 3%),表现为细胞毒性水肿和(或)血管源性水肿。DWI异常12例,累及中脑7例、丘脑8例、海马2例、基底节1例、侧脑室旁白质1例、胼胝体1例; T2WI Flair异常17例,累及侧脑室旁白质14例、丘脑6例、中脑3例、海马2例、基底节1例。结论成人乙型脑炎多以高热、意识障碍起病,部分以急性肢体瘫痪起病,临床表现和影像学特点与脑梗死相似,鉴别靠血清学和病原学检测。乙型脑炎主要累及中脑、丘脑、基底节、海马、侧脑室旁白质和胼胝体,表现为细胞毒性水肿和(或)血管源性水肿,个别患者治疗后T2WI Flair侧脑室旁白质异常高信号减少。更多还原

【Abstract】 Objective To investigate the clinical and imaging characteristics of adult Japanese encephalitis.Methods The clinical data of 30 adult patients with Japanese encephalitis were analyzed retrospectively. Results The majority of adult Japanese encephalitis is the elderly. High fever was in 30 cases at onset,consciousness disorder was in 22 cases,acute paralysis was in 4 cases,headache was in 6 cases,nausea and vomiting was in 4 patients,dizziness was in 2 cases,slow reaction was in 2 cases,unclear articulation was in 1 case,epilepsy was in 1 case.There was 22 patients finished examination of MRI,and 17( 77. 3%) had abnormal MRI result. The abnormal signals could be cytotoxic edema or angiogenic edema. DWI shows abnormal signal in 12 cases,involving midbrain in7 cases,thalamus in 8 cases,hippocampus in 2 cases,basal ganglia in 1 case,lateral ventricle white matter in1 case,corpus callosum in 1 case. T2 WI flair shows abnormal signal in 17 cases,involving lateral ventricle white matter in 14 cases,thalamus in 6 cases,midbrain in 3 cases,hippocampus in 2 cases,and basal ganglia in 1 cases.Conclusions The major onset of adult Japanese encephalitis forms are high fever and consciousness disorder,and some patients may also have acute onset of paralysis of limbs. The clinical and imaging features are similar to those of cerebral infarction. Identification depends on serological and pathogenic tests. Midbrain,thalamus,basal ganglia,hippocampus,lateral ventricular collateral and the corpus callosum are involved in Japanese encephalitis patient. It can be shown as cytotoxic edema or angiogenic edem. The abnormal high signal in the lateral ventricle white matter of T2 WI flair reduced after treatment was in individual patient.更多还原