韦尼克脑病的MRI表现及DWI对临床预后的评价

目的:探讨韦尼克脑病(Wernicke’s encephalopathy,WE)的MRI表现及弥散加权成像(DWI)在临床预后及治疗中的价值。方法:对10例经临床证实的WE患者的MRI资料进行分析,同时DWI检查,8例行MRI复查并对治疗前后病灶表观弥散系数(ADC)值进行比较。结果:5例患者均出现双侧丘脑、第三脑室及导水管周围广泛对称性异常信号累及,乳头体、被盖及四脑室底部异常信号各1例。上述病变呈稍长T1稍长T2信号改变,FLAIR序列呈高信号。DWI显示10例病灶区呈高/稍高信号,5例患者治疗前ADC值减低,其中3例经治疗后复查ADC值升高;另外5例患者病灶区治疗前ADC值无明显下降,治疗后ADC值均升高,患者预后均较好。结论:WE脑病具有典型的MRI表现,DWI对临床诊断及预后评价具有重要意义。

MRI diagnosis of Wernicke's encephalopathy and clinical prognosis evaluation with diffusion-weighted imaging

Objective：To explore the MRI findings of Wernicke encephalopathy （WE） and to characterize the value of DWI in its diagnosis,treatment and prognosis assessment.Methods：MRI data of ten cases WE were prospectively analyzed.The ADC values pre-and post-treatment were also compared in eight cases.Results：Symmetrical abnormal signal intensity was shown in bilateral thalamus, the area around the third ventricle and aqueduct in five cases,in the area around tectal plate in six cases and in mammillary body in five cases,as well as in periventricular gray matter located anterior to the fourth ventricle in seven cases.Above-mentioned lesions showed long-T1,long-T2 signal intensity and hypertensity on FLAIR sequence.Lesions in all cases showed hyperintensity on diffusion-weighted images with decreased ADC vaues（0.53～0.60×10-3 mm2/s） in five cases,three of which improved after treatment with increased ADC values（0.90～1.09×10-3 mm2/s）.Conclusion：WE has typical MR imaging findings and DWI is of great value in clinical diagnosis and prognosis assessment.