Department of Radiology, Medical University of Bialystok, Bialystok, Poland; TMS Diagnostyka, Bialystok, Poland.
Department of Radiology, Medical University of Bialystok, Bialystok, Poland; TMS Diagnostyka, Bialystok, Poland.
Int J Infect Dis. 2018 Mar;68:26-30. doi: 10.1016/j.ijid.2018.01.002. Epub 2018 Jan 11.
Magnetic resonance imaging (MRI) changes in tick-borne encephalitis (TBE) are non-specific and the pathophysiological mechanisms leading to their formation remain unclear. This study investigated brain perfusion in TBE patients using dynamic susceptibility-weighted contrast-enhanced magnetic resonance perfusion imaging (DSC-MRI perfusion).
MRI scans were performed for 12 patients in the acute phase, 3-5days after the diagnosis of TBE. Conventional MRI and DSC-MRI perfusion studies were performed. Cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), and time to peak (TTP) parametric maps were created. The bilateral frontal, parietal, and temporal subcortical regions and thalamus were selected as regions of interest. Perfusion parameters of TBE patients were compared to those of a control group.
There was a slight increase in CBF and CBV, with significant prolongation of TTP in subcortical areas in the study subjects, while MTT values were comparable to those of the control group. A significant increase in thalamic CBF (p<0.001) and increased CBV (p<0.05) were observed. Increased TTP and a slight reduction in MTT were also observed within this area.
The DSC-MRI perfusion study showed that TBE patients had brain perfusion disturbances, expressed mainly in the thalami. These results suggest that DSC-MRI perfusion may provide important information regarding the areas affected in TBE patients.
蜱传脑炎（TBE）的磁共振成像（MRI）改变是非特异性的，导致其形成的病理生理机制仍不清楚。本研究使用动态磁敏感对比增强磁共振灌注成像（DSC-MRI 灌注）研究 TBE 患者的脑灌注。
对 12 例 TBE 确诊后 3-5 天的急性期患者进行 MRI 扫描。进行常规 MRI 和 DSC-MRI 灌注研究。创建脑血流量（CBF）、脑血容量（CBV）、平均通过时间（MTT）和达峰时间（TTP）参数图。选择双侧额、顶、颞皮质下区和丘脑作为感兴趣区。将 TBE 患者的灌注参数与对照组进行比较。
研究对象皮质下区域的 CBF 和 CBV 略有增加，TTP 明显延长，而 MTT 值与对照组相似。观察到丘脑 CBF 明显增加（p<0.001）和 CBV 增加（p<0.05）。该区域还观察到 TTP 延长和 MTT 略有减少。
DSC-MRI 灌注研究表明，TBE 患者存在脑灌注障碍，主要表现在丘脑。这些结果表明 DSC-MRI 灌注可能为 TBE 患者受累区域提供重要信息。
