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目的探讨病毒性脑炎的核磁共振成像(MRI)和扩散加权成像(DWI)表现。方法71例病毒性脑炎患者,28例颅内有病灶者为A组,43例颅内无病灶者为B组;100例正常成人作为对照组。3组均进行常规MRI及DWI检查,比较病毒性脑炎与正常成人的额叶白质、颞叶白质、侧脑室旁及基底节-丘脑区的平均表观扩散系数(ADC)值的差异。结果 A组病毒性脑炎患者额叶白质、颞叶白质、侧脑室旁及基底节-丘脑区的平均ADC值分别为(1.070±0.21)×10-3mm2/s、(1.110±0.21)×10-3mm2/s、(1.080±0.19)×10-3mm2/s、(1.030±0.18)×10-3mm2/s;B组病毒性脑炎患者额叶白质、颞叶白质、侧脑室旁及基底节-丘脑区的平均ADC值分别为(0.789±0.05)×10-3mm2/s、(0.813±0.04)×10-3mm2/s、(0.789±0.04)×10-3mm2/s、(0.779±0.03)×10-3mm2/s;正常成人的额叶白质、颞叶白质、侧脑室旁及基底节-丘脑区的平均ADC值分别为(0.7961±0.04)×10-3mm2/s、(0.805±0.05)×10-3mm2/s、(0.785±0.03)×10-3mm2/s、(0.770±0.02)×10-3mm2/s。A组的平均ADC值较B组及对照组均升高,差异具有统计学意义(P均<0.05),而B组与对照组差异无统计学意义(P均>0.05)。结论DWI及ADC可反映病毒性脑炎病变组织的微观结构变化信息,是常规MRI非常有价值的补充,与临床诊断相结合,有助于病毒性脑炎的诊断。但在病毒性脑炎早期尚未形成可见的颅内病灶者,MRI包括DWI及ADC对病毒性脑炎的诊断受到限制,尚需进一步探讨。
Objective To investigate the MRI and diffusion-weighted imaging (DWI) manifestations of viral encephalitis. Methods 71 patients with viral encephalitis, 28 patients with intracranial lesions were Group A, 43 patients without intracranial lesions were Group B; 100 normal adults as control group. The MRI and DWI were performed in all three groups. The mean apparent diffusion coefficient (ADC) values of frontal white matter, temporal lobe white matter, lateral ventricle and basal ganglia-thalamus were compared between viral encephalitis and normal adults. Results The mean ADC values of frontal white matter, temporal lobe white matter, lateral ventricle and basal ganglia-thalamus in group A were (1.070 ± 0.21) × 10-3mm2 / s, (1.110 ± 0.21) × 10- (1.080 ± 0.19) × 10-3mm2 / s, (1.030 ± 0.18) × 10-3mm2 / s in group B patients with frontal lobe white matter, temporal lobe white matter, lateral ventricle and basal ganglia-thalamus The average ADC values of the region were (0.789 ± 0.05) × 10-3mm2 / s, (0.813 ± 0.04) × 10-3mm2 / s, (0.789 ± 0.04) × 10-3mm2 / s and (0.779 ± 0.03) × 10 -3mm2 / s. The average ADC value of normal white matter, temporal lobe white matter, lateral ventricle and basal ganglia-thalamus were (0.7961 ± 0.04) × 10-3mm2 / s, (0.805 ± 0.05) × 10- 3mm2 / s, (0.785 ± 0.03) × 10-3mm2 / s, (0.770 ± 0.02) × 10-3mm2 / s. The average ADC value of group A was higher than that of group B and control group (P <0.05), but there was no significant difference between group B and control group (all P> 0.05). Conclusion DWI and ADC can reflect the changes of the microstructure of viral encephalitis tissue. It is a very valuable supplement to conventional MRI. Combined with clinical diagnosis, DWI and ADC are helpful to the diagnosis of viral encephalitis. However, in the early stage of viral encephalitis, no visible intracranial lesions have been formed. MRI, including DWI and ADC, have limited the diagnosis of viral encephalitis, and further study is needed.