MRI对Wernicke脑病的诊断及鉴别诊断

目的探讨MRI对Wernicke脑病（WE）的诊断价值。方法回顾性分析7例经临床治疗确诊WE患者的临床资料及MRI检查结果。结果7例患者中，6例可见导水管周围对称性异常信号，5例可见双侧丘脑、第三脑室周围、乳头体对称性异常信号，2例可见丘脑下部异常信号。所有病灶呈现T2加权像高信号，T1加权像略低信号。病灶边界模糊，DWI及FLAIR序列呈高信号，2例Gd—DTPA增强后病变区域呈斑点状对比强化，临床治疗后病灶范围均有所变小，上述病灶CT检查均无异常改变。结论Wernicke脑病的MRI表现有其特异性，T2-FLAIR有利于病灶显示，DWI对WE的早期诊断价值更高。

Differential diagnosis of MRI on Wernicke encephalopathy

Objective To evaluate the value of MRI in the diagnosis of Wernicke encephalopathy （WE）. Methods The clinical and MR imaging data of 7 patients with clinically-proved WE were analyzed retrospectively. Results Six cases showed symmetrical abnormal signal in the area around midbrain aqueduct on MRI, and 5 cases in the medial bilateral thalamus, the third cerebral ventricle and mammillary body, and 2 cases in the lower part of thalamus. All cases showed high signal on T2WI, DWI, and FLAIR, and slightly low signal on T1WI with blurred signal edges. The lesion area of 2 cases showed spotted contrast enhancement with Gd-DTPA. All cases showed no abnormal change on CT examination. The lesions volume is smaller by clinical treatment. Conclusion Wemicke encephalopathy has definite MR imaging findings. The lesions are easy to display on T2WI and FLAIR. The DWI has an important role in early diagnosis of WE.