腹部手术后并发Wernicke脑病的MRI诊断

目的探讨腹部手术后并发Wernicke脑病患者的临床及MRI表现特点,以提高对该病的认识和诊断水平。材料与方法搜集4例腹部术后并发Wernicke脑病患者的临床及MRI资料,结合文献进行回顾性分析。结果 4例患者中2例表现为嗜睡,1例表现为神志淡漠,1例表现为精神萎靡、言语及运动减少。MRI上4例均可见内侧丘脑、第三脑室旁及导水管周围、对称分布的斑片状稍长T1、长T2异常信号,FLAIR序列均呈高信号,DWI(b=1000 s/mm~2)上部分病灶呈稍高信号或高信号,1例行增强扫描,病灶未见明显强化。结论 Wernicke脑病MRI具有一定特征,结合临床病史将有助于该病的提示性诊断。

The diagnose of MRI in Wernicke encephalopathy after abdominal operation

AbstractObjective:To investigate the clinical and MRI characteristics of Wernicke encephalopathy after abdominal operation, in order to improve the understanding and diagnostic level of it.Materials and Methods:Retrospectively analyzed the collected clinical and imaging data of four nonalcoholic Wernicke encephalopathy patients after abdominal operation and reviewed the reference literature.Results: Two of the four patients were lethargy, one patient showed spiritual apathy, another one patient performed as listlessness and lacking language and movement. All of the four patients were underwent MR imaging which showed that the symmetric lesions located in the medial thalamus, periventricular region of the third ventricle and the periaqueductal grey matter. Their signals were symmetric slight hyperintensity on T2-weighted images, lfuid-attenuated inversion recovery (FLAIR) images and hypointensity on T1-weighted images. Some lesions also showed slight hyperintensity or hyperintensity in DWI images. One patient was performed contrast enhanced scan, but the lesions were not obviously enhanced.Conclusions: The MR signals of nonalcoholic Wernicke encephalopathy had certain speciifcity, and the clinical manifestation combined with brain MRI examination will be helpful to diagnose of it.