Agarwal Rajan, Sze Gordon
Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT 06520, USA.
Radiology. 2009 Oct;253(1):167-73. doi: 10.1148/radiol.2531081103. Epub 2009 Jul 8.
To describe the neuroimaging manifestations of Lyme disease at magnetic resonance (MR) imaging of the brain.
Institutional review board approval was obtained and HIPAA compliance was followed. This study retrospectively reviewed the MR imaging findings of all patients seen from 1993 to 2007 in whom neuro-Lyme disease was suspected and who were referred for MR imaging of the brain for the evaluation of neurologic symptoms.
Of 392 patients suspected of having neuro-Lyme disease, 66 patients proved to have the disease on the basis of clinical criteria, serologic results, and response to treatment. Seven of these 66 patients showed foci of T2 prolongation in the cerebral white matter, one had an enhancing lesion with edema, and three demonstrated nerve-root or meningeal enhancement. Of the seven patients with foci of T2 prolongation in the white matter, three were an age at which white matter findings due to small-vessel disease are common.
In cases of nerve-root or meningeal enhancement, Lyme disease should be considered in the differential diagnosis in the proper clinical setting.
描述莱姆病在脑部磁共振成像（MR）中的神经影像学表现。
获得机构审查委员会批准并遵循健康保险流通与责任法案（HIPAA）规定。本研究回顾性分析了1993年至2007年间所有疑似神经莱姆病且因神经系统症状被转诊进行脑部MR成像评估的患者的MR成像结果。
在392例疑似神经莱姆病的患者中，66例根据临床标准、血清学结果及对治疗的反应被证实患有该病。这66例患者中，7例脑白质出现T2加权像高信号灶，1例有强化病灶伴水肿，3例显示神经根或脑膜强化。在7例脑白质出现T2加权像高信号灶的患者中，3例处于因小血管疾病导致白质改变常见的年龄阶段。
在出现神经根或脑膜强化的病例中，在适当的临床背景下鉴别诊断时应考虑莱姆病。
