摘要
目的探讨伴可逆性胼胝体压部损伤轻度脑炎/脑病（MERS）的MRI影像亚型区分的可能性及意义;研究MERS患者胼胝体膝部（GCC）是否会被同步累及以及治疗后恢复情况。方法回顾性分析27例经证实为MERS的临床及磁共振资料,观察病变的MRI特征。测量首次MRI成像及治疗后第一次复查胼胝体压部（SCC）及GCC相同面积病灶感兴趣区（ROI）的表观扩散系数（ADC）值共四组,并计算其平均值;采用配对样本t检验对比治疗前、后SCC及GCC的ADC值差异性,采用独立样本t检验,比较治疗后第一次复查SCC和GCC平均ADC值的差异性。结果病变形态在Ⅰ型MERS中呈圆形、橄榄形及＂回旋镖＂形三种亚型,Ⅱ型MERS病变形态包括整个胼胝体或邻近的白质或两者兼有的多发片状,具有轴对称特点。治疗前、后SCC的ADC值有显著性差异（t=-9.953,P〈0.05）;治疗前、后GCC的ADC值差异有统计学意义（t=-4.071,P〈0.05）;治疗后第一次复查SCC与GCC的ADC值无显著性差异（t=-1.028,P〉0.05）。结论Ⅰ型MERS可从MRI影像进一步区分出三个亚型。MERSⅠ型急性期GCC同样有轻微的扩散受限,治疗后亦好转,MERS病变实际涉及区域可能较以往认知的范围更广。
Objective To explore the possibility and significance of subtypes of the mild encephalitis/encephalopathy with a reversible splenial lesion（ MERS） by MRI. Investigate whether the genu of the corpus callosum（ GCC） can be involved in and recovered in MERS patients. Methods A retrospective review was performed of 27 cases who had been confirmed to have MERS in nearly five years,and clinical and MRI features of the lesion were found. Splenium of the corpus callosum（ SCC） and GCC lesions ADC value were measured for the same area ROI for the initial MRI examination and the first MRI follow-up after the treatment,and mean value for statistical analysis was calculated. The ADC values difference of SCC and GCC before and after treatment were compared by the paired sample t-test method. The ADC values difference between SCC and GCC after treatment were compared by the independent sample t-test method. Results Type I MERS can further distinguish three subtypes from MR images（ Ia-circle,Ib-oval,Ic-Boomerang）. The ADC values of SCC before and after treatment were significantly different（ t =-9. 953,P 0. 05）. The ADC values of GCC before and after treatment were significantly different（ t =-4. 071,P 0. 05）. There was no significant difference in the ADC value between SCC and GCC after the treatment（ t =-1. 028,P 0. 05）. Conclusion The location and morphology of intracranial lesions in MERS lesions are highly recognizable. MERS Type I can further distinguish three subtypes from MR images（ Ia-circle,Iboval,Ic-Boomerang）. GCC have a slight diffusion restriction in MERS type I acute stage; after treatment,the diffusion restriction also reduced as it does in SCC,The range of lesions in MERS may be wider than previously thought.
作者
杨擎
王雄
黄大祥
朱娟
汪飞
余永强
YANG Qing;WANG XIONG;HUANG Daxiang(AnHui Medical University,Meishan road,Hefei,Anhui Province 230032,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2018年第9期1431-1435,共5页
Journal of Clinical Radiology
关键词
可逆性
胼胝体压部
亚型
表观扩散系数值
Splenium of the corpus callosum
Transient lesion
Magnetic resonance
Subtype
