Hatta S, Mochizuki H, Kuru Y, Miwa H, Kondo T, Mori H, Mizuno Y
Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan.
Neuroradiology. 1994 May;36(4):285-8. doi: 10.1007/BF00593261.
We report serial neuroradiological studies in a patient with focal cerebritis in the head of the left caudate nucleus. On the day after the onset of symptoms, CT showed an ill-defined low density lesion. The lack of contrast enhancement appeared to be the most important finding for differentiating focal cerebritis from an encapsulated brain abscess or a tumour. MRI two days later revealed the centre of the lesion to be of slightly low intensity on T1-weighted inversion recovery (IR) images and very low intensity on T2-weighted spin echo images, which appeared to correspond to the early cerebritis stage of experimentally induced cerebritis and brain abscess. Ten days after the onset of symptoms, CT revealed a thin ring of enhancement in the head of the caudate nucleus, and a similar small ring was seen in the hypothalamus 16 days after the onset, corresponding to the late cerebritis stage. MRI nine days later revealed ill-defined high signal lesions within the involved area on the T1-weighted IR images. To our knowledge, this is the first published MRI documentation of the early cerebritis stage developing into an encapsulated brain abscess. The mechanisms underlying of these radiographic changes are discussed.
我们报告了一例左侧尾状核头部局灶性脑脊髓炎患者的系列神经放射学研究。症状出现后的第二天，CT显示一个边界不清的低密度病变。缺乏对比增强似乎是区分局灶性脑脊髓炎与包膜性脑脓肿或肿瘤的最重要发现。两天后的MRI显示，在T1加权反转恢复（IR）图像上，病变中心呈略低信号强度，在T2加权自旋回波图像上呈极低信号强度，这似乎与实验性诱导的脑脊髓炎和脑脓肿的早期脑脊髓炎阶段相对应。症状出现十天后，CT显示尾状核头部有一个薄的强化环，症状出现十六天后，在下丘脑也可见类似的小环，对应于脑脊髓炎后期。九天后的MRI显示，在T1加权IR图像上，受累区域内有边界不清的高信号病变。据我们所知，这是首次发表的关于早期脑脊髓炎阶段发展为包膜性脑脓肿的MRI记录。本文讨论了这些影像学改变的潜在机制。
