Gerber S, Biondi A, Dormont D, Wechsler B, Marsault C
Department of Neuroradiology, Pitié-Salpêtrière Hospital, University of Paris VI, France.
Neuroradiology. 1996 Nov;38(8):761-8. doi: 10.1007/s002340050343.
To study the long-term evolution of cerebral lesions in neuro-Behçet's disease, MRI was carried out on 12 patients, with follow-up from 1.5 to 6 years (mean 3.5 years). On the first MRI, 66 lesions in all were found; each patient had 1-10 lesions (mean 5.5). There were 30 (46%) lesions in the brain stem, 18 (27%) in the basal ganglia region and 18 (27%) in the periventricular white matter. Of these 22 (33%) were small, 31 (47%) medium-size and 13 (20%) large lesions. On the last MRI, 60 lesions were found: each patient had 1-10 lesions (mean 5). At this time 31 lesions (52%) were in the brain stem, 13 (22%) in the basal ganglia region and 16 (26%) in the periventricular white matter. There were 41 (68%) small, 13 (22%) medium-size and 6 (10%) large lesions. About 40% of the lesions disappeared, 35% reduced in size and 25% remained unchanged. No lesion had enlarged. Of the 60 final lesions 20 (34%) were not observed on the first study. Small new lesions were found in 5 of 12 patients (42%), and were asymptomatic. Medium-size or large new lesions were found in 2 patients (17%) who had stopped steroid treatment and had a neurological relapse. Enlargement of the ventricular system or worsening of initial cerebral atrophy was observed in 9 of 12 patients. Appearance of small lesions and worsening of cerebral atrophy on long-term follow-up suggest the possibility of subclinical progression of cerebral vasculitis and should be considered in the prognosis of neuro-Behçet's disease.
为研究神经白塞病脑损害的长期演变情况，对12例患者进行了MRI检查，随访时间为1.5至6年（平均3.5年）。首次MRI检查时，共发现66个损害；每位患者有1至10个损害（平均5.5个）。其中30个（46%）损害位于脑干，18个（27%）位于基底节区，18个（27%）位于脑室周围白质。这些损害中，22个（33%）为小损害，31个（47%）为中等大小损害，13个（20%）为大损害。末次MRI检查时，发现60个损害；每位患者有1至10个损害（平均5个）。此时，31个（52%）损害位于脑干，13个（22%）位于基底节区，16个（26%）位于脑室周围白质。有41个（68%）小损害，13个（22%）中等大小损害，6个（10%）大损害。约40%的损害消失，35%的损害缩小，25%的损害无变化。无损害增大。在60个最终损害中，20个（34%）在首次检查时未被发现。12例患者中有5例（42%）发现了无症状的小的新损害。2例（17%）停用类固醇治疗并出现神经功能复发的患者发现了中等大小或大的新损害。12例患者中有9例观察到脑室系统扩大或初始脑萎缩加重。长期随访中出现小损害及脑萎缩加重提示脑血管炎亚临床进展的可能性，在神经白塞病的预后评估中应予以考虑。
