Yedavalli Vivek, Lanzman Bryan
Stanford University, Department of Radiology, Division of Neuroradiology and Neurointervention, 300 Pasteur Drive, Room S047, Palo Alto, CA 94305, USA.
Stanford University, Department of Radiology, Division of Neuroradiology and Neurointervention, 300 Pasteur Drive, Room S092, MC 5105, Palo Alto, CA 94305, USA.
Radiol Case Rep. 2019 Nov 9;15(1):77-81. doi: 10.1016/j.radcr.2019.10.011. eCollection 2020 Jan.
Metronidazole induced encephalopathy (MIE) is a rare condition due to prolonged high dose administration of metronidazole. MIE with corresponding increased perfusion on MRI arterial spin labeling (ASL) of the involved regions of the brain appears not to have been reported in the literature to date. We present two such cases, a 59-year-old male with recurrent C difficile colitis with classic MR imaging characteristics of MIE, and a companion case of a 65-year-old female with gangrenous cholecystitis also presumed to have MIE. Despite aggressive medical management, both patients expired. Our cases demonstrate a correlation with ASL hyperperfusion to affected brain regions thought to be due to edema or inflammation. Perfusion imaging may play a role in diagnosis of MIE.
甲硝唑诱发的脑病（MIE）是一种因长期高剂量使用甲硝唑导致的罕见病症。脑磁共振动脉自旋标记（ASL）显示受累脑区灌注相应增加的MIE，迄今文献中似乎尚无报道。我们报告两例此类病例，一例是一名59岁男性，患有复发性艰难梭菌结肠炎，具有MIE的典型磁共振成像特征；另一例是一名65岁女性，患有坏疽性胆囊炎，也被推测患有MIE。尽管积极进行了药物治疗，两名患者均死亡。我们的病例显示，受累脑区与ASL高灌注存在相关性，推测这是由水肿或炎症所致。灌注成像可能在MIE的诊断中发挥作用。
