迟发性拉斯穆森脑炎的PET与MRI纵向评估：三例系列报道
Longitudinal PET and MRI Evaluation in Late Onset Rasmussen Encephalitis: A Series of Three Cases.
作者信息
Rozenblum Laura, Chougar Lydia, Bielle Franck, Mathon Bertrand, Navarro Vincent, Dupont Sophie, Kas Aurélie
机构信息
Department of Nuclear Medicine, Pitié-Salpêtrière Hospital, APHP, Sorbonne Université, Paris, France.
INSERM, CNRS, Laboratoire D'imagerie Biomédicale, Sorbonne University, Paris, France.
出版信息
Eur J Neurol. 2025 Jul;32(7):e70266. doi: 10.1111/ene.70266.
BACKGROUND
Rasmussen's encephalitis (RE) is a rare, chronic, neurological disorder characterized by progressive focal epilepsy and hemispheric atrophy. Late-onset RE poses diagnostic challenges due to atypical clinical features and nonspecific early MRI findings.
METHODS
This case series underscores the value of [18F]FDG PET in detecting unihemispheric hypometabolism and crossed cerebellar diaschisis at diagnosis, before MRI changes appear.
RESULTS
During follow-up, PET identified active disease through hypermetabolic foci or pseudo-normalized metabolism, indicative of subclinical seizures, while stable hypometabolism signaled quiescence.
CONCLUSION
Combining PET with MRI enhances diagnostic accuracy and guides treatment decisions in managing RE.
背景
拉斯穆森脑炎（RE）是一种罕见的慢性神经疾病，其特征为进行性局灶性癫痫和半球萎缩。晚发型RE因临床特征不典型及早期MRI表现不具特异性而带来诊断挑战。
方法
本病例系列强调了[18F]FDG PET在MRI改变出现之前的诊断中检测单侧半球代谢减低和交叉性小脑神经机能联系失联络的价值。
结果
在随访期间，PET通过高代谢灶或代谢伪正常化识别出活动期疾病，提示亚临床癫痫发作，而稳定的代谢减低则表明疾病静止。
结论
PET与MRI相结合可提高RE诊断的准确性并指导治疗决策。
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