目的 对边缘性脑炎患者磁共振(MR)影像学表现进行探讨,以明确急性边缘性脑炎的特异性磁共振影像学征象,了解磁共振成像(MRI)在急性边缘性脑炎患者诊断以及病情评价中的应用价值。 方法 通过对2008年12月-2010年1月间临床收集的8例边缘性脑炎患者进行MRI检查,并回顾性分析不同序列磁共振影像学表现,总结MRI征象,评价MRI检查在急性边缘性脑炎的临床诊治中的作用。 结果 边缘性脑炎患者显示特异性的双侧边缘系统肿胀及信号异常,呈T1WI低信号影;T2WI及FLAIR成像为高信号影像;增强扫描未见确切异常强化;FLAIR成像是检测病变最敏感的序列。部分患者可见累及边缘系统外结构。随访病例影像学改变可有明显好转。 结论 边缘性脑炎特异性损伤边缘系统,以双侧海马为主,MRI影像可直观反映边缘性脑炎早期及随访期改变,能直接了解边缘性脑炎颅内受累范围、程度及治疗后恢复情况等,可为其临床及时诊断及治疗评估提供有利信息。
ObjectiveTo make a better understanding of potassium channel-complex autoimmune antibodies associated limbic encephalitis, we studied in details with patients of this autoimmune disease accompanying without tumors. MethodsDiagnosis of 3 patients were confirmed by antibody detection in serum or CSF. All the clinical data, including history, CSF data, cranial MRI, EEG, pelvic ultrasound and treatment strategy, were carefully gathered. Two to eleven months follow-up were carried out. Results3 female adult patients showed common initial manifestation of seizures, and changes of consciousness, mental disorder and cognitive impairment. Hyponatremia was found in one LGI1-Ab+ patient. Cranial MRI showed unilateral or bilateral signal changes with limbic system. Changes of CSF and EEG were nonspecific. All 3 patients became recovery in different levels after two to eleven months. ConclusionsPotassium channel-complex antibodies associated encephalitis may be a common type of limbic encephalitis in adults without tumors. Seizures may be the first sign of the disease. Hyponatremia is one of characteristics of LGI1-Ab+ patient. Patients may have a fairly good short outcome.