Finelli Pasquale F, Foxman Ethan B
Department of Neurology, Hartford Hospital and University of Connecticut School of Medicine; Hartford, CT, USA -
Department of Radiology, Hartford Hospital and University of Connecticut School of Medicine; Hartford, CT, USA.
Neuroradiol J. 2014 Jun;27(3):280-7. doi: 10.15274/NRJ-2014-10036. Epub 2014 Jun 17.
This study describes a series of cases and reviews the literature on cases of ring lesion on diffusion-weighted imaging to better appreciate the spectrum of disease associated with this neuroimaging finding. We retrospectively reviewed the MR studies of 15 patients with ring pattern lesions on diffusion-weighted imaging from an inpatient Neurology service of a tertiary care center seen over a ten-year period, and reviewed cases in the literature. Thirty-one cases, including 15 new patients, comprise the study group. Immunocompromised patients accounted for 38% of patients with ring lesions on diffusion-weighted imaging with cerebral aspergillosis in five patients, progressive multifocal leukoencephalopathy in three, primary CNS lymphoma in two, cerebral toxoplasmosis in one, and resolving cerebral hematoma in one. In the immunocompetent group demyelinating lesions including multiple sclerosis, acute disseminated encephalomyelitis, Balo's concentric sclerosis and acute necrotizing encephalitis, were seen in 11 patients, vascular etiology in four and neoplastic in three patients, two primary and one metastatic and pyogenic brain abscess in one. Ring lesions on diffusion-weighted imaging are associated with a spectrum of disease not previously considered. Immunocompromised patients accounted for almost one-half while demyelinating conditions in the immunocompetent patients were most common overall.
本研究描述了一系列病例，并回顾了关于扩散加权成像上环形病变病例的文献，以更好地了解与这一神经影像学表现相关的疾病谱。我们回顾性分析了一家三级医疗中心神经内科住院部在十年期间收治的15例扩散加权成像上有环形病变的患者的磁共振成像研究，并回顾了文献中的病例。包括15例新患者在内的31例病例构成了研究组。免疫功能低下患者占扩散加权成像上有环形病变患者的38%，其中5例为脑曲霉病，3例为进行性多灶性白质脑病，2例为原发性中枢神经系统淋巴瘤，1例为脑弓形虫病，1例为正在吸收的脑血肿。在免疫功能正常组中，11例患者出现脱髓鞘病变，包括多发性硬化、急性播散性脑脊髓炎、巴洛同心性硬化和急性坏死性脑炎，4例为血管性病因，3例为肿瘤性病因，其中2例为原发性，1例为转移性，1例为化脓性脑脓肿。扩散加权成像上的环形病变与一系列以前未被考虑的疾病相关。免疫功能低下患者占近一半，而免疫功能正常患者的脱髓鞘疾病总体上最为常见。
