- 期刊
Magnetic Resonance Imaging of Herpes Simpiex Encephalitis
單純型疱疹病毒腦炎之磁振造影
摘要
此篇針對七位幼兒及兒童，診斷爲單純型疱疹病毒腦炎，其八次的腦部磁振造影及一次的脊髓磁振造影，做一回顧性之研究。顳葉是最常見的病灶部位，在灰質及白質處，於T1造影顯現低信號區，而於T2造影顯現高信號區。於四位病人(57%)，可以發現有出血病灶。在這些病人中，早期的白質侵犯，甚至於早到第四天，是一項常見的磁振造影發現。有一位病人是復發性腦脊髓炎，其脊髓磁振造影於腰部脊髓至髓錐處，於T2造影顯現出廣泛性的高信號區。除了一位病人死亡外，所有存活的病人均有嚴重的神經後遣症。我們的結果顯示於單純型疱疹病毒腦炎的病人，磁振造影是一第三的診斷方法早期的白質侵犯，並非少見的磁振造影的發現。於復發性單純型疱疹病毒腦脊髓炎的病例，脊髓磁振造影對於診斷上，可能有所助益。
並列摘要
Eight brain magnetic resonance imagings (MRIs) and one spinal MRI of 7 small infants and children with herpes simplex encephalitis (HSE) were retrospectively studied. Hypointense and hyperintense areas of gray and white matters on T1- and T2- weighted images, respectively, were commonly present, with temporal lobes being the most common lesion sites. Hemorrhagic lesions were found in 4 patients (57%). Early involvement of the white matter, as early as day 4, was a common MRI finding in these patients. One patient had relapsed encephalomyelitis, whose spinal MRI showed diffuse hyperintense T2 signals from the lumbar spinal cord to the conus medullaris. All patients but one survived with major neurological sequelae. Our results indicate that MRI is a sensitive diagnostic modality in cases of HSE, and early involvement of white matter is not an uncommon MRI finding of HSE. Spinal MRI may be helpful in the diagnosis of relapsed herpes encephalomyelitis.