Service d'Imagerie 2, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France.
ICANS, Service de Médecine Nucléaire, 67000 Strasbourg, France.
Viruses. 2022 May 1;14(5):949. doi: 10.3390/v14050949.
Cerebral complications related to the COVID-19 were documented by brain MRIs during the acute phase. The purpose of the present study was to describe the evolution of these neuroimaging findings (MRI and FDG-PET/CT) and describe the neurocognitive outcomes of these patients.
During the first wave of the COVID-19 outbreak between 1 March and 31 May 2020, 112 consecutive COVID-19 patients with neurologic manifestations underwent a brain MRI at Strasbourg University hospitals. After recovery, during follow-up, of these 112 patients, 31 (initially hospitalized in intensive care units) underwent additional imaging studies (at least one brain MRI).
Twenty-three men (74%) and eight women (26%) with a mean age of 61 years (range: 18-79) were included. Leptomeningeal enhancement, diffuse brain microhemorrhages, acute ischemic strokes, suspicion of cerebral vasculitis, and acute inflammatory demyelinating lesions were described on the initial brain MRIs. During follow-up, the evolution of the leptomeningeal enhancement was discordant, and the cerebral microhemorrhages were stable. We observed normalization of the vessel walls in all patients suspected of cerebral vasculitis. Four patients (13%) demonstrated new complications during follow-up (ischemic strokes, hypoglossal neuritis, marked increase in the white matter FLAIR hyperintensities with presumed vascular origin, and one suspected case of cerebral vasculitis). Concerning the grey matter volumetry, we observed a loss of volume of 3.2% during an average period of approximately five months. During follow-up, the more frequent FDG-PET/CT findings were hypometabolism in temporal and insular regions.
A minority of initially severe COVID-19 patients demonstrated new complications on their brain MRIs during follow-up after recovery.
COVID-19 相关的脑部并发症在急性期通过脑部 MRI 记录。本研究的目的是描述这些神经影像学发现（MRI 和 FDG-PET/CT）的演变，并描述这些患者的神经认知结果。
在 2020 年 3 月 1 日至 5 月 31 日 COVID-19 爆发的第一波期间，112 例连续出现神经系统表现的 COVID-19 患者在斯特拉斯堡大学附属医院接受了脑部 MRI 检查。在这些 112 例患者康复后的随访期间，31 例（最初住院于重症监护病房）接受了额外的影像学研究（至少一次脑部 MRI）。
23 例男性（74%）和 8 例女性（26%），平均年龄为 61 岁（范围：18-79 岁）。在初始脑部 MRI 上描述了脑膜强化、弥漫性脑微出血、急性缺血性中风、疑似脑血管炎和急性炎症性脱髓鞘病变。在随访期间，脑膜强化的演变不一致，脑微出血稳定。我们观察到所有疑似脑血管炎患者的血管壁均恢复正常。4 例患者（13%）在随访期间出现新的并发症（缺血性中风、舌下神经神经炎、推测血管源性的白质 FLAIR 高信号显著增加和一例疑似脑血管炎）。关于灰质容积，我们观察到在大约五个月的平均期间内体积损失了 3.2%。在随访期间，更常见的 FDG-PET/CT 发现是颞叶和岛叶区域的代谢低下。
少数最初病情严重的 COVID-19 患者在康复后的随访期间其脑部 MRI 上出现新的并发症。
