Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.
J Neuroimaging. 2023 Nov-Dec;33(6):917-925. doi: 10.1111/jon.13143. Epub 2023 Jun 25.
Wernicke's encephalopathy (WE) is a severe acute disorder related to thiamine deficiency. This study was aimed at revealing the relationship between clinical and imaging findings and WE recovery.
We retrospectively reviewed 34 cases of WE diagnosed between 2003 and 2020 (median age: 57 years, 14 females) at two academic institutions. WE cases were divided into two groups with symptomatic recovery within 4 weeks (group 1) or later (group 2). The lesion sites were divided into typical and atypical sites (total sites defined as when either typical or atypical sites were involved). Clinical and MRI features were compared between them as appropriate.
WE patients were divided into group 1 (19 cases, median age: 57 years, 10 females) and group 2 (15 cases, median age: 57 years, four females). Regarding clinical features, only cerebellar ataxia was more often observed in group 1 than in group 2. Regarding MRI features, signal abnormality on T2-weighted image (WI)/fluid-attenuated inversion recovery (FLAIR) was more often observed in atypical sites between groups 1 and 2 (1/19 vs. 7/15; p = .01). There were significant differences between groups 1 and 2 regarding the presence of both vasogenic edema and cytotoxic edema in total sites (4/11 vs. 11/15, p = .005; 1/19 vs. 6/15, p = .03), with a significant difference in the presence of vasogenic edema in typical sites (4/19 vs. 10/15, p = .01).
The early recovered group showed a lower incidence of T2WI/FLAIR abnormality in atypical sites and diffusion signal abnormality in total or typical sites with a lower incidence of cerebellar ataxia.
Wernicke 脑病（WE）是一种与硫胺素缺乏相关的严重急性疾病。本研究旨在揭示临床和影像学表现与 WE 恢复之间的关系。
我们回顾性分析了 2003 年至 2020 年在两家学术机构诊断的 34 例 WE 患者（中位年龄：57 岁，14 例女性）。将 WE 病例分为症状在 4 周内恢复（第 1 组）或更晚恢复（第 2 组）的两组。将病变部位分为典型部位和非典型部位（总部位定义为涉及典型或非典型部位）。适当比较两组之间的临床和 MRI 特征。
WE 患者分为第 1 组（19 例，中位年龄：57 岁，10 例女性）和第 2 组（15 例，中位年龄：57 岁，4 例女性）。在临床特征方面，第 1 组比第 2 组更常出现小脑性共济失调。在 MRI 特征方面，第 1 组和第 2 组之间非典型部位的 T2 加权图像（WI）/液体衰减反转恢复（FLAIR）信号异常更为常见（1/19 比 7/15；p = 0.01）。第 1 组和第 2 组之间总部位存在血管源性水肿和细胞毒性水肿的比例有显著差异（4/11 比 11/15，p = 0.005；1/19 比 6/15，p = 0.03），典型部位存在血管源性水肿的比例有显著差异（4/19 比 10/15，p = 0.01）。
早期恢复组在非典型部位 T2WI/FLAIR 异常和总部位或典型部位弥散信号异常的发生率较低，且小脑性共济失调的发生率较低。
Zotero 插件