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[单纯疱疹病毒性脑炎:神经放射学鉴别诊断]

[Herpes simplex virus encephalitis: neuroradiologic differential diagnosis].

作者信息

Struffert T, Reith W

机构信息

Abteilung für Neuroradiologie, Radiologische Klinik, Universität des Saarlandes, 66421 Homburg/Saar.

出版信息

Radiologe. 2000 Nov;40(11):1011-6. doi: 10.1007/s001170050873.

Abstract

Herpes simplex virus encephalitis (HSE) is the most frequent viral encephalitis, as a rule with the starting point and centre within the temporal lobe. If untreated, HSE is usually fatal, thus diagnosis has to be established rapidly. Treatment with Acyclovir should begin as soon as possible. As MRI is extremely sensitive in detecting the early inflammatory changes, it should be initially performed, especially as in the early stadium CT may be unspecific. We recommend the following examination protocol: coronar T1-weighted MR imaging before and after administration of gadopentetate dimeglumine, coronar FLAIR sequence and axial T2-weighted imaging. The diagnostic proof is to show the evidence of viral DNA by polymerase chain reaction (PCR) in cerebrospinal liquor.

摘要

单纯疱疹病毒性脑炎(HSE)是最常见的病毒性脑炎,通常起病点及病变中心位于颞叶。若不治疗,HSE通常会致命,因此必须迅速做出诊断。应尽快开始使用阿昔洛韦进行治疗。由于MRI在检测早期炎症变化方面极其敏感,应首先进行MRI检查,尤其是在疾病早期,CT可能表现不具特异性。我们推荐以下检查方案:静脉注射钆喷酸葡胺前后的冠状位T1加权磁共振成像、冠状位液体衰减反转恢复序列(FLAIR)及轴位T2加权成像。诊断依据是通过脑脊液聚合酶链反应(PCR)显示病毒DNA的证据。

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