急性播散性脑脊髓炎的临床及MRI表现(附1例报告)

目的探讨急性播散性脑脊髓炎（ADEM）的临床与影像学表现。方法回顾性分析1例ADEM患者的临床资料。结果本例患者临床表现为急性起病,头昏、恶心、呕吐;头部MRI显示双侧脑室周围及额、颞、顶、枕白质区见多发圆形、不对称长T1、长T2信号灶。病理检查示脑组织有炎症及血管周围淋巴细胞套形成。经部分病灶切除术、脱水、抗感染等治疗无效,糖皮质激素治疗效果显著。结论对有头昏、恶心、呕吐等症状,MRI出现大脑白质多灶性损害者,应考虑ADEM的可能,本病糖皮质激素治疗效果显著。

Clinical and MRI manifestations of acute disseminated encephalomyelitis: report of one case

Objective To investigate the clinical and magnetic resonance imaging (MRI) manifestations of acute disseminated encephalomyelitis (ADEM).Methods The clinical, neuroimaging and neuropathological data of a patient with ADEM were analyzed retrospectively.Results The clinical features of the patient included acute onset,paroxysmal dizziness, nausea and vomiting. Cerebral MRI showed multiple, asymmetrical, long T1 and long T2 signals, which appeared periventricular areas and white matter regions of frontal, parietal, occipital and temporal lobe. Pathologic examination showed brain tissue denaturalization with chronic inflammation and massive inflammatory lymphocyte infiltrations in perivascular spaces. Treatments such as surgery operation, dehydration and anti-infection were invalid, while glucocorticosteroid had stable therapeutic efficacy.Conclusions When a patient presents with dizziness, nausea and vomiting, and multifocal lesions appear in the white matter of brain in MRI, the diagnosis of ADEM must be taken into concern. Curative effect of glucocorticosteroid for this disease is confirmed.