Kubota Tetsuo, Ito Miharu, Maruyama Koichi, Kato Yuichi, Miyajima Yuji, Ogawa Akimasa, Kuno Kuniyoshi, Okumura Akihisa, Watanabe Kazuyoshi
Department of Pediatrics, Anjo Kosei Hospital, Aichi, Japan.
Brain Dev. 2007 Apr;29(3):171-3. doi: 10.1016/j.braindev.2006.08.003. Epub 2006 Sep 18.
We reported a patient with neonatal herpes simplex encephalitis in whom diffusion-weighted imaging was performed repeatedly. Diffusion-weighted imaging at 20h after the onset of seizures revealed scattered small spotty high intensity lesions in both hemispheres and a high intensity area in the left fronto-temporal lobe. There was no abnormal finding on conventional magnetic resonance imaging. Second diffusion-weighted imaging 72h after the onset revealed expanded scattered high intensity lesions in the bilateral hemisphere, a high intensity area in the left fronto-temporal lobe, and a new high intensity area in the right temporal lobe. There was no report on neonatal herpes simplex encephalitis that showed scattered high intensities in diffusion-weighted imaging. Scattered small high intensities on diffusion-weighted imaging may suggest endothelial cell infection with swelling and small vessel necrosis. Early diffusion-weighted imaging will be valuable for early detection and diagnosis of neonatal herpes simplex encephalitis.
我们报告了一名患有新生儿单纯疱疹性脑炎的患者，对其进行了多次弥散加权成像检查。癫痫发作后20小时的弥散加权成像显示双侧半球散在小斑点状高信号病变以及左侧额颞叶的一个高信号区。常规磁共振成像未发现异常。发作后72小时的第二次弥散加权成像显示双侧半球散在的高信号病变范围扩大，左侧额颞叶有一个高信号区，右侧颞叶出现一个新的高信号区。尚无关于新生儿单纯疱疹性脑炎在弥散加权成像中显示散在高信号的报道。弥散加权成像上散在的小高信号可能提示内皮细胞感染伴肿胀和小血管坏死。早期弥散加权成像对于新生儿单纯疱疹性脑炎的早期检测和诊断具有重要价值。
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