Antunez E, Estruch R, Cardenal C, Nicolas J M, Fernandez-Sola J, Urbano-Marquez A
Department of Internal Medicine, Alcohol Unit Generalitat-Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Spain.
AJR Am J Roentgenol. 1998 Oct;171(4):1131-7. doi: 10.2214/ajr.171.4.9763009.
In this study, we analyzed the sensitivity and specificity of CT and MR imaging in the diagnosis of acute Wernicke's's encephalopathy.
Three groups of subjects were studied: 15 patients with acute Wernicke's encephalopathy; 15 asymptomatic alcoholics; and 15 control subjects. Studies included clinical and laboratory examinations as well as CT and MR imaging of the brain.
On CT scans, two patients with Wernicke's encephalopathy (13%) and no asymptomatic alcoholics showed low-density abnormalities in the paraventricular regions of the thalamus (p = .2414). On MR imaging, increased T2 signal of paraventricular regions of the thalamus was observed in seven patients (46%) with Wernicke's encephalopathy and one asymptomatic alcoholic (6%) (p < .01), and increased T2 signal of periaqueductal regions of the midbrain in six patients (40%) with Wernicke's encephalopathy and one asymptomatic alcoholic (6%) (p < .05). However, no significant differences were observed in the prevalence of mamillary body shrinkage between alcoholics with Wernicke's encephalopathy (six [40%]) and asymptomatic chronic alcoholics (four [27%]). The sensitivity of MR imaging in revealing evidence of this disease was 53% and the specificity, 93%.
MR imaging is useful in confirming the diagnosis of acute Wernicke's encephalopathy. However, the absence of abnormalities on MR imaging does not exclude this diagnosis. CT proved not useful in the diagnosis of Wernicke's encephalopathy.
在本研究中，我们分析了CT和MR成像在急性韦尼克脑病诊断中的敏感性和特异性。
研究对象分为三组：15例急性韦尼克脑病患者；15例无症状酗酒者；以及15例对照者。研究包括临床和实验室检查以及脑部CT和MR成像。
在CT扫描中，2例韦尼克脑病患者（13%）出现丘脑室旁区域低密度异常，无症状酗酒者未出现（p = 0.2414）。在MR成像中，7例（46%）韦尼克脑病患者和1例（6%）无症状酗酒者丘脑室旁区域T2信号增强（p < 0.01），6例（40%）韦尼克脑病患者和1例（6%）无症状酗酒者中脑导水管周围区域T2信号增强（p < 0.05）。然而，韦尼克脑病酗酒者（6例[40%]）和无症状慢性酗酒者（4例[27%]）之间乳头体萎缩发生率无显著差异。MR成像显示该病证据的敏感性为53%，特异性为93%。
MR成像有助于确诊急性韦尼克脑病。然而，MR成像无异常并不能排除该诊断。CT被证明对韦尼克脑病的诊断无用。
