病毒性脑炎的MRI诊断及预后的分析

目的:探讨病毒性脑炎MRI影像的表现特点、检查方法的选用,以及病毒性脑炎MRI影像表现与临床预后的关系。方法:回顾分析经临床确诊的35例病毒性脑炎MRI及临床资料,所有病例常规做SE序列:轴位T1WI、T2WI,矢状位T1WI,必要时加扫T2WI冠状位,5例加扫FLAIR序列,增强28例。结果:MRI主要表现为T1WI呈稍低或等信号,T2WI呈稍高异常信号,FLAIR序列呈明显高信号。结论:MRI可早期发现病毒性脑炎,是病毒性脑炎影像学检查的首选方法;对病毒性脑炎的定位、定性诊断及预后评价具有重要价值,FLAIR序列比SE序列显示病变更清晰,MRI表现病灶累及范围越广泛,则预后越差,经治疗后影像学检查仍出现异常者预后不良。

MRI DIAGNOSIS OF VIRAL ENCEPHALITIS AND ITS PROGNOSTIC ANALYSIS

Objective: To explore the MRI presentative characteristics of vir al encephalitis and toevaluate the relationship between the MRI diagnosis of vir al encephalitis and the clinic prognosis. Methods: MRI findings in all 35 cases with clinically proved viral encephalitis were retr ospectively analyzed. The axial T1WI, T2WI and sagittal T1WI in all cases were p erformed routinely and coronal T2WI was added if necessary. The 28 cases were Gd-DTPA-enhanced and 5 cases FLAIR sequences. Results: The MRI manifestations of viral encephalitis showed the viral encephalitis had relatively low or equal signal on T1-weighted images and relatively high signal on T2-weighted images, high signal intensity on FLAIR sequences. Conclusion: MRI could find the viral encephalitis in the early stags and this method should be the first choice for imaging examinations in diagnosing of viral encephalitis. MRI has high value in the dianosis, treatment and follow-up of the viral encephalitis. Viral encephali tis were showed on FLAIR sequences better than on SE sequences. The more the extent of the disease involved, the worse the prognosis would be. Therefore, the prognosis might be bad if the abnormalities still remain on MRI after antibiotic therapy.