Wang Lin-Jing, Kong De-Zheng, Guo Zhen-Ni, Zhang Fu-Liang, Zhou Hong-Wei, Yang Yi
Department of Radiology, First Hospital of Jilin University, Changchun, China.
Department of Neurology, First Hospital of Jilin University, Changchun, China.
J Stroke Cerebrovasc Dis. 2019 Apr;28(4):920-928. doi: 10.1016/j.jstrokecerebrovasdis.2018.12.007. Epub 2019 Jan 8.
To summarize the characteristics of primary central nervous system vasculitis from clinical, imaging, and pathological aspects by retrospective study.
From March 2015 to December 2017, the data of the inpatients of primary central nervous system vasculitis in first Hospital of Jilin University were collected, and their clinical manifestation, imaging, and pathological characteristics were analyzed by using a descriptive method.
There were 18 patients, 10 males (55.56%) and 8 females (44.44%) separately. The age ranges from 16 years old to 49 years old, with the median age of 32 years old. There were 8 cases (44.44%) of epileptic seizure, 6 cases (33.33%) of abnormal behavior and cognition, 10 cases (55.56%) with sensorimotor abnormalities, 4 cases (22.22%) with dizziness, 4 cases (22.22%) with headache, 2 cases (11.11%) with facial pain, 2 cases (11.11%) with blurred vision, and 2 cases (11.11%) with unstable walking. Eight patients (44.44%) were identified with cerebral spinal fluid abnormalities. There were 12 cases (66.67%) with bilateral lesions and 6 cases (33.33%) with unilateral lesions, including the frontal lobe (18 cases, 100%), the parietal lobe (10 cases, 55.56%), the temporal and occipital lobe (8 cases, 44.44%). There were 12 cases (66.67%) combined with subcortical white matter involvement, 6 cases (33.33%) combined with meningeal involvement, 2 cases (11.11%) complicated with basal ganglia involvement and 2 cases (11.11%) complicated with spinal cord involvement. Most of the lesions were with unclear border (16 cases, 88.89%), 2 cases (11.11%) were with clear border. Cortical atrophy was identified in 6 cases (33.33%). There were 12 cases (66.67%) with the enhancement of the lesions and meningeal. The 3D Vessel Wall magnetic resonance imaging (VW-MRI) showed uniform thickness in all patients (18/18) with contrast enhancement of the vessel wall of the vasculitis artery.
The clinical manifestation and imaging in primary central nervous system vasculitis are diverse. The 3D VW-MRI could achieve quantification assessment of vasculitis and provide more utility for primary angiitis of the central nervous system.
通过回顾性研究从临床、影像学和病理学方面总结原发性中枢神经系统血管炎的特征。
收集吉林大学第一医院2015年3月至2017年12月原发性中枢神经系统血管炎住院患者的数据，采用描述性方法分析其临床表现、影像学和病理学特征。
共18例患者，男性10例（55.56%），女性8例（44.44%）。年龄范围为16岁至49岁，中位年龄32岁。癫痫发作8例（44.44%），行为和认知异常6例（33.33%），感觉运动异常10例（55.56%），头晕4例（22.22%），头痛4例（22.22%），面部疼痛2例（11.11%），视力模糊2例（11.11%），行走不稳2例（11.11%）。8例患者（44.44%）脑脊液异常。双侧病变12例（66.67%），单侧病变6例（33.33%），累及额叶18例（100%），顶叶10例（55.56%），颞叶和枕叶8例（44.44%）。合并皮质下白质受累12例（66.67%），合并脑膜受累6例（33.33%），合并基底节受累2例（11.11%），合并脊髓受累2例（11.11%）。多数病变边界不清（16例，88.89%），边界清晰2例（11.11%）。6例（33.33%）有皮质萎缩。12例（66.67%）病变及脑膜有强化。三维血管壁磁共振成像（3D VW-MRI）显示所有患者（18/18）血管壁厚度均匀，血管炎动脉血管壁有对比增强。
原发性中枢神经系统血管炎的临床表现和影像学表现多样。3D VW-MRI可实现对血管炎的定量评估，为中枢神经系统原发性血管炎提供更多实用价值。
