【摘要】 目的探讨抗NMDAR脑炎的临床特点、影像表现及意义。方法回顾性分析陕西省人医院2014-01—2020-08确诊的11例抗NMDAR脑炎患者的临床及影像资料。结果 11例患者为急性或亚急性起病,首发症状表现为精神症状2例,认知功能损害2例,痫性发作4例,非特异性症状3例。11例患者的脑脊液抗NMDAR抗体均为阳性,其中2例脑脊液HSV抗体阳性,1例脑脊液麻疹病毒抗体阳性。头颅MRI 7例表现为侧脑室旁、岛叶、颞叶、额叶及海马等部位高T2FLAIR信号,4例未见明显病灶。MRI首次阳性者,病灶范围会随病情好转而缩小或加重而增大。MRI首次阴性者,复查可出现阳性或仍为阴性。结论抗NMDAR脑炎临床表现复杂多样,MRI阳性者结合临床特点可提示诊断,动态观察MRI表现可反映疾病进展、演变。更多还原

【Abstract】 Objective To explore the clinical characteristics,imaging manifestations and significance of anti-NMDAR encephalitis.Methods The clinical and imaging data of 11 patients with anti-NMDAR encephalitis diagnosed in our hospital from January2014 to August 2020 were retrospectively analyzed.Results Eleven patients had acute or subacute onset.Two patients showed psychiatric symptoms first,2 patients were cognitive impairment,4 patients were seizures,and 3 patients were non-specific symptoms.All the 11 patients had anti-NMDAR antibody in their cerebrospinal fluid,including 2 patients with HSV antibody and 1 patient with measles virus antibody.Seven cases of cranial MRI showed high T2 FLAIR signal in the lateral ventricle,insula,temporal lobe,frontal lobe and hippocampus,and 4 cases showed no obvious lesions.The MRI lesions area will shrink or increase as the condition improves.If MRI didn’t show lesion firstly,the reexamination may be show some lesion or still no lesion.Conclusion The clinical manifestations of anti-NMDAR encephalitis are complex and diverse.Imaging manifestations combined with clinical features can prompt the diagnosis,and dynamic observation of MRI manifestations can reflect disease progression and evolution.更多还原