MRI对Wernicke脑病的临床诊断价值

目的：探讨MRI对Wernicke脑病（wE）的临床诊断价值。方法：回顾性分析16例经临床诊断为WE患者的临床及MRI影像资料。结果：16例患者中表现为意识障碍及精神症状者13例，视力障碍或眼肌麻痹者7例，共济失调者9例；12例患者脑部MRI图像可见第三、四脑室旁、中脑导水管周围、乳头体、四叠体、丘脑等部位不同程度对称性水肿，9例DWI（b=1000s／mm2）图像病灶呈高信号，增强扫描病灶部分区域可强化。4例患者脑部MRI无异常表现。结论：MRI可为Wernicke脑病的临床早期诊治及判断预后提供有效信息，但部分病例MRI可无异常表现，故临床有相关病史且出现类似症状却无异常MR征象时，也应考虑到本病。

Value of MRI in the clinical diagnosis of Wernicke encephalopathy

Objective： To study the value of MRI in the clinical diagnosis of Wernicke encephalopathy （WE）. Methods：The clinical and MRI manifestations of 16 patients with clinically diagnosed WE were retrospectively analyzed. Results：Of the 16 patients, 13 patients had different level of disturbance of consciousness and mental symptoms,7 patients presented with visual impairment or ophthalmoplegia,9 patients had ataxia. On MRI, 12 patients showed different degree of symmetric edema adjacent to the third and fourth ventricle, aquaeductus mesencephali, mammillary bodies, quadrigeminal bodies and thalamus. 9 patients had DWI （b= 1000s/mm2） ,showing hyper-intensity of the lesions. After contrast adminis- tration, part of the lesions showed enhancement. No abnormality within the brain were assessed on MRI in 4 patients. Con- clusion：MRI provides helpful information for early diagnosis and prognosis prediction of Wernicke encephalopathy. Yet, some WE patients showed no abnormality on MRI, therefore WE should also be considered in patients showing similar clini- cal history and symptoms.