| 宋海乔,强军,高万勤,黄丽娜,马国瑞,鲁果果.早期流行性乙型脑炎弥散加权成像表现及T2廓清效应特点[J].中国医学影像技术,2020,36(12):1771~1775 |
| 早期流行性乙型脑炎弥散加权成像表现及T2廓清效应特点 |
| Characteristics of diffusion weighted imaging and T2 washout in early stage of epidemic encephalitis type B |
| 投稿时间：2019-12-18 修订日期：2020-11-30 |
| DOI：10.13929/j.issn.1003-3289.2020.12.003 |
| 中文关键词: 弥散磁共振成像 表观弥散系数 流行性乙型脑炎 |
| 英文关键词:diffusion magnetic resonance imaging apparent diffusion coefficient epidemic encephalitis type B |
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| 中文摘要: |
| 目的 探讨早期流行性乙型脑炎（简称乙脑）的弥散加权成像（DWI）表现及T2廓清效应特点。方法 回顾性分析51例乙脑患者，观察其好发部位及DWI、表观弥散系数（ADC）图、T2WI及液体衰减反转恢复（FLAIR）等信号特点。结果 乙脑好发部位主要为丘脑（41/51，80.39%）、脑干（黑质和脑桥）（28/51，54.90%）及海马（16/51，31.37%）。14例DWI呈高信号、ADC图呈低信号；7例DWI呈稍高信号，16例DWI呈等信号，ADC图、T2WI、FLAIR均呈稍高或高信号；4例DWI、ADC图、T2WI、FLAIR均呈高信号；10例DWI呈高、稍高或等信号共存，ADC图呈高、低信号共存，T2WI和FLAIR呈等或稍高、高信号共存。乙脑急性期细胞毒性水肿、血管源性水肿及2种类型共存病例发病时间差异无统计学意义（χ2=1.771，P=0.413）。结论 早期乙脑DWI表现不同，廓清效应可使病灶表现为假性正常，综合ADC图及常规序列可避免漏诊。 |
| 英文摘要: |
| Objective To explore the characteristics of diffusion weighted imaging (DWI) and T2 washout effect in early diagnosis of epidemic encephalitis type B. Methods Totally 51 patients with epidemic encephalitis type B were retrospectively analyzed. The common location of epidemic encephalitis type B lesions and their signal characteristics on DWI, apparent diffusion coefficient (ADC), T2WI and fluid attenuated inversion recovery (FLAIR) were observed. Results The common sites of epidemic encephalitis type B were thalamus (41/51, 80.39%), brainstem (substantia nigra and pons) (28/51, 54.90%) and hippocampus (16/51, 31.37%). High signals on DWI and low signals on ADC were observed in 14 cases, slightly high signals on DWI were found in 7 cases, while 16 cases showed isointense signals on DWI and slightly high or high signals on ADC, T2WI and FLAIR images. DWI, ADC, T2WI and FLAIR all showed high signals in 4 cases, while in 10 cases, high, slightly high or isointense signals were noticed on DWI, with high and low ADC signals, isointense or slightly high or high signals on T2WI and FLAIR images. There was no significant difference on the onset time among the cases with acute phase cytotoxic edema, angiogenic edema nor two types coexisting or both (χ2=1.771, P=0.413). Conclusion The early DWI manifestations of epidemic encephalitis type B were different. The impact of washout effect could lead to false normal appearance of lesions. Combining ADC image and routine MR sequences could be helpful to avoiding missed diagnosis. |
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