Petropoulou Kalliopi A, Gordon Steven M, Prayson Richard A, Ruggierri Paul M
Department of Radiology, Section of Neuroradiology, the Cleveland Clinic Foundation, Cleveland, OH, USA.
AJNR Am J Neuroradiol. 2005 Sep;26(8):1986-95.
Reports of MR imaging in West Nile virus (WNV) meningoencephalomyelitis are few and the described findings limited. The purpose of this study was to review the spectrum of MR imaging findings for WNV meningoencephalomyelitis and investigate whether any of the findings correlates with clinical presentation of flaccid paralysis.
We reviewed the MR imaging findings of 17 patients with confirmed WNV encephalitis and/or myelitis. MR imaging brain studies were evaluated for location of signal intensity abnormalities, edema, hydrocephalus, or abnormal enhancement. MR imaging spine studies were evaluated for signal intensity abnormalities in cord and/or enhancement.
Retrospective review of the MR imaging studies of 17 patients was performed by 2 neuroradiologists. Eleven of 16 brain MR images demonstrated abnormalities. Eight (50%) patients had abnormal studies related to meningoencephalitis. All 8 patients had abnormal findings in the deep gray matter and/or brain stem; 2 had additional white matter abnormalities. Three patients with abnormal MR studies of the spine had extremity weakness on examination. The imaging findings included abnormal signal intensity more pronounced in the ventral horns and/or enhancement around the conus medullaris and cauda equina. One patient had additional abnormalities in the pons.
Abnormal MR imaging findings in patients with WNV meningoencephalomyelitis are nonspecific but not uncommon. Anatomic areas commonly affected are basal ganglia, thalami, mesial temporal structures, brain stem, and cerebellum. Extremity weakness or flaccid paralysis corresponds to spinal cord/cauda equina abnormalities.
关于西尼罗河病毒（WNV）脑膜脑脊髓炎的磁共振成像（MR）报告较少，且所描述的发现有限。本研究的目的是回顾WNV脑膜脑脊髓炎的MR成像表现谱，并调查是否有任何发现与弛缓性麻痹的临床表现相关。
我们回顾了17例确诊为WNV脑炎和/或脊髓炎患者的MR成像结果。对脑部MR成像研究进行评估，以确定信号强度异常、水肿、脑积水或异常强化的位置。对脊柱MR成像研究进行评估，以确定脊髓信号强度异常和/或强化情况。
2名神经放射科医生对17例患者的MR成像研究进行了回顾性分析。16例脑部MR图像中有11例显示异常。8例（50%）患者有与脑膜脑炎相关的异常研究。所有8例患者在深部灰质和/或脑干有异常发现；2例有额外的白质异常。3例脊柱MR研究异常的患者在检查时有肢体无力。成像结果包括腹侧角信号强度异常更明显和/或圆锥马尾周围强化。1例患者脑桥有额外异常。
WNV脑膜脑脊髓炎患者的MR成像异常表现不具有特异性，但并不罕见。常见受累的解剖区域是基底节、丘脑、颞叶内侧结构、脑干和小脑。肢体无力或弛缓性麻痹与脊髓/马尾异常相对应。
