Weber W, Henkes H, Felber S, Jänisch W, Schaper J, Kühne D
Klinik für Radiologie und Neuroradiologie, Alfried-Krupp-Krankenhaus, Alfried-Krupp-Strasse 21, 45117 Essen.
Radiologe. 2000 Nov;40(11):998-1010. doi: 10.1007/s001170050872.
The diagnostic procedure in viral encephalitis is based on the synopsis of clinical signs and symptoms, serological data, CSF analysis and diagnostic imaging findings. This article summarizes the findings of those viral encephalitides most frequently encountered in Western Europe. MRI is more sensitive than CT for the detection of inflammatory brain lesions due to the higher contrast resolution. The pattern of parenchymal damage is highly specific in only some viral encephalitides (e.g., the frequently hemorrhagic lesions of structures of the limbic system in herpes simplex virus type I encephalitis; the symmetric and confluent lesions of the frontal white matter of progressive diffuse leukoencephalopathy in AIDS). In the majority of viral encephalitides MRI demonstrates the location and extension of parenchymal damage. The specific diagnosis in terms of the causative agent is based on serological studies.
病毒性脑炎的诊断程序基于临床体征和症状、血清学数据、脑脊液分析及诊断性影像学检查结果的综合判断。本文总结了在西欧最常见的那些病毒性脑炎的研究结果。由于具有更高的对比度分辨率，MRI在检测炎性脑病变方面比CT更敏感。仅在某些病毒性脑炎中，脑实质损害的模式具有高度特异性（例如，I型单纯疱疹病毒性脑炎中边缘系统结构常见的出血性病变；艾滋病相关的进行性弥漫性白质脑病中额叶白质的对称性融合性病变）。在大多数病毒性脑炎中，MRI可显示脑实质损害的部位和范围。病原体的特异性诊断基于血清学研究。
