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中华临床医师杂志(电子版) ›› 2020, Vol. 14 ›› Issue (12) : 1009 -1012. doi: 10.3877/cma.j.issn.1674-0785.2020.12.011

所属专题: 文献

综述

自身免疫性脑炎影像学特征的研究进展
徐秦岚1, 孟雪1, 刘献增1,()   
  1. 1. 102206 北京,北京大学国际医院神经内科
  • 收稿日期:2020-06-18 出版日期:2020-12-15
  • 通信作者: 刘献增

Research progress of imaging features of autoimmune encephalitis

Qinlan Xu1, Xue Meng1, Xianzeng. Liu1,()   

  1. 1. Department of Neurology, Peking University International Hospital, Beijing 102206, China
  • Received:2020-06-18 Published:2020-12-15
  • Corresponding author: Xianzeng. Liu
引用本文:

徐秦岚, 孟雪, 刘献增. 自身免疫性脑炎影像学特征的研究进展[J]. 中华临床医师杂志(电子版), 2020, 14(12): 1009-1012.

Qinlan Xu, Xue Meng, Xianzeng. Liu. Research progress of imaging features of autoimmune encephalitis[J]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(12): 1009-1012.

自身免疫性脑炎(AE)的诊断取决于临床症状、影像学和抗体,确诊依赖抗体及免疫治疗反应,但抗体检测普及性差、抗体阴性及早期免疫治疗反应不明显不能除外该病。细胞内抗原相关的AE其头颅MRI常表现为颞叶内侧异常,而细胞表面抗原相关AE头颅MRI常为正常或颞叶内侧以外的区域异常,不同类型AE急性期FDG-PET表现不同,但晚期所有AE患者均可出现不同程度的脑萎缩,其中以海马萎缩多见。因此,影像学如头颅MRI检查在AE早期确诊中具有十分重要的作用。此外,FDG-PET具有高敏感性,在AE诊断中受到了越来越多的重视。本文总结分析不同类型AE的结构影像和代谢影像学表现,提高其在AE早期诊断和治疗中的应用。

The diagnosis of autoimmune encephalitis depends on symptoms, imaging, and autoantibodies. However, the detection of autoantibodies has poor popularity, and the negative result of autoantibodies or no significant immunotherapy response in the early stage cannot rule out the disease. Cerebral MRI of intracellular antigen-related limbic encephalitis often shows abnormalities in the medial temporal lobe, while cell-surface antigen-associated encephalitis is usually normal or abnormal in areas other than the medial temporal lobe. Different autoantibody-associated encephalitis has different FDG-PET manifestations in the acute phase, but all patients with encephalitis in the later stage can have different degrees of brain atrophy, with hippocampal atrophy being more common. Therefore, imaging modalities such as head MRI play a very important role in early diagnosis. And because of it high sensitivity, FDG-PET has attracted wide attention in detecting autoimmune encephalitis. Here we review the MRI and FDG-PET findings in different types of AE, with an aim to improve its application in early screening and diagnosis of AE.

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