拉斯姆森脑炎患者早期脑18F-FDG PET呈阳性而MRI呈阴性

Early Positive Brain 18F-FDG PET and Negative MRI in Rasmussen Encephalitis.

作者信息

Thomé Ursula, Machado Hélio Rubens, Santos Marcelo Volpon, Santos Antonio Carlos, Wichert-Ana Lauro

机构信息

From the Epilepsy Surgery Center, Department of Neuroscience and Behavioral Sciences.

Division of Neurosurgery, Department of Surgery and Anatomy.

出版信息

Clin Nucl Med. 2023 Mar 1;48(3):240-241. doi: 10.1097/RLU.0000000000004521. Epub 2023 Jan 10.

DOI:10.1097/RLU.0000000000004521

PMID:36723884

Abstract

A 15-year-old adolescent boy with left body epilepsia partialis continua, hemiparesis, and electroencephalogram abnormalities lateralized to the right hemisphere. MRI finding was small hyperintense signal in the left putamen. 18F-FDG PET showed focal glucose hypermetabolism in the right paracentral lobule and hypometabolism in the inferior right frontal and precentral gyri. One month later, a new MRI showed a hyperintense signal over the paracentral lobule. Biopsy on this region confirmed the diagnosis of Rasmussen encephalitis. This patient finally underwent right hemispherotomy and became seizure free. This case emphasize the PET as an important early tool for the diagnosis of Rasmussen encephalitis.

摘要

一名15岁青少年男性，患有左侧身体持续性部分性癫痫、偏瘫，脑电图异常定位于右侧半球。MRI检查发现左侧壳核有小的高信号。18F-FDG PET显示右侧中央旁小叶有局灶性葡萄糖高代谢，右侧额下回和中央前回代谢减低。1个月后，新的MRI显示中央旁小叶有高信号。该区域活检确诊为拉斯穆森脑炎。该患者最终接受了右侧大脑半球切除术，术后无癫痫发作。本病例强调了PET作为拉斯穆森脑炎重要早期诊断工具的作用。