Department of Radiology, Section of Neuroradiology, University of California Davis Medical Center, USA.
Department of Neurology (Neuroimmunulogy), University of California Davis Medical center, USA.
Neuroradiol J. 2022 Apr;35(2):152-169. doi: 10.1177/19714009211042879. Epub 2021 Sep 7.
There is an extensive spectrum of autoimmune entities that can involve the central nervous system, which has expanded with the emergence of new imaging modalities and several clinicopathologic entities. Clinical presentation is usually non-specific, and imaging has a critical role in the workup of these diseases. Immune-mediated diseases of the brain are not common in daily practice for radiologists and, except for a few of them such as multiple sclerosis, there is a vague understanding about differentiating them from each other based on the radiological findings. In this review, we aim to provide a practical diagnostic approach based on the unique radiological findings for each disease. We hope our diagnostic approach will help radiologists expand their basic understanding of the discussed disease entities and narrow the differential diagnosis in specific clinical scenarios. An understanding of unique imaging features of these disorders, along with laboratory evaluation, may enable clinicians to decrease the need for tissue biopsy.
有广泛的自身免疫实体可以涉及中枢神经系统，随着新的成像方式和几种临床病理实体的出现，这一范围已经扩大。临床表现通常是非特异性的，影像学在这些疾病的检查中起着关键作用。对于放射科医生来说，脑免疫介导性疾病在日常实践中并不常见，除了少数几种疾病，如多发性硬化症，他们对根据影像学发现将这些疾病彼此区分开来的理解还比较模糊。在这篇综述中，我们旨在根据每种疾病的独特影像学发现提供一种实用的诊断方法。我们希望我们的诊断方法将帮助放射科医生扩展他们对所讨论疾病实体的基本理解，并在特定临床情况下缩小鉴别诊断范围。对这些疾病独特影像学特征的理解，以及实验室评估，可能使临床医生减少对组织活检的需求。
