%0 Journal Article
%T 癫痫持续状态引起的脑部异常MRI表现
%A 陈文伙
%A 陈跃鸿
%A 杨妙雄
%A 吴宗忠
%A 巫超鑫
%A 石炎川
%A 陈柏龄
%A 郭婷辉
%A 易婷玉
%A 张梅芳
%J 华西医学
%P 900-903
%D 2011
%X 【】　目的　探讨癫痫持续状态引起的脑部异常MRI表现的特点。　方法　回顾分析2004年―2007年5例患者由癫痫持续状态引起的脑部异常MRI表现，患者均在发作后72h内行头颅MRI检查，常规进行了T2WI、T1WI、液体衰减反转恢复序列、弥散加权成像（diffusion-weightedimaging，DWI），同时进行了磁共振血管造影（magneticresonanceangiography，MRA）及增强扫描。　结果　5例患者均由部分性发作泛发为全面性强直-阵挛发作，均在发作后行MRI时出现明显单侧大脑半球异常表现，且与部分性发作侧相对应，在T2WI上均表现为局部皮层肿胀，呈高信号，其中3例DWI上出现皮层高信号，病灶不按脑血管分布。4例在MRA上出现病灶同侧大脑中动脉血管较对侧明显增多。5例行增强扫描后均见病灶侧脑膜明显强化。5例患者临床发作后均遗留有与MRI异常病灶相应的临床神经功能缺失。其中3例病情稳定后复查MRI，发现异常病灶及MRA完全恢复正常。　结论　癫痫持续状态引起脑部异常MRI表现特点①常局限于大脑皮层的T2WI、DWI高信号，且病灶不按血管分布区分布；②MRA提示单侧脑血管增多；③增强扫描见单侧脑膜强化。大部分病灶可逆。这些特点可用来区别是癫痫引起的异常病灶还是脑部的致痫灶。【Abstract】　Objective　TosummarizethecharacteristicsofabnormalMRIfindingsofbraincausedbystatusepilepticus.　Methods　WeretrospectivelyanalyzedtheabnormalMRIfindingsofbraininfivepatientswithstatusepilepticusfrom2004to2007.AllofthemreceivedMRIexaminationwithin72hoursafterseizures,includingtheroutineexaminationofT2WI,T1WI,FLAIRanddiffusion-weightedimaging(DWI).Meanwhile,MRAandenhancementscanningwerecarriedout.ThreeofthemwerereexaminedwithMRIafterthediseasecameintoastablecondition.　Results　Allthefivepatientstransferredfrompartialseizuresinitiallytogeneralizedtonicclonicseizures,andobviousabnormalMRIfindingsweredetectedattheunilateralcerebralhemisphere,correspondingtothesideofpartialseizures.TheyappearedregionalswellingofcortexwithhighsignalinT2WI,andthreecaseswerefoundwithcortexhighsignalsinDWI,whichwerenotdistributedaccordingtocerebralvessels.Infourcases,wefoundthatthebranchesofthemiddlecerebralarteryincreasedmarkedlythanthecontralateralbranchesontheipsilaterallesionsinMRA.Enhancementscanningalsoshowedthatthemeningesatthesideofthelesionwasstrengthenedsignificantlyinfivecases.ThelossofneurologicalfunctionscorrespondingtoabnormallesionsinMRremainedafterseizuresinfivecasesamongwhomthreepatientsrecoveredcompletelyintermsoftheirabnormalfocusesandMRAfindingsaftertheirdiseasescameintoastablecondition.　Conclusions　ThefeaturesofabnormalbrainMRIfindingscausedbystatusepilepticusare①HighsignalsinT2WIandDWIareconfinedtothecortex,andthefocusesarenotdistributedaccordingtocerebralvessels;②MRAshowsthatunilateralcerebralvesselsincreasesinnumber;③Strengthenedunilateralmeningescanbeobservedinenhancedscanningandmostoflesionsarereversible.Accordingthecharacteristics,wecandistinguishtheabnormallesionscausedbyepilepsyfromfocusesinthebraincausingepilepsy.
%K 癫痫持续状态
%K MRI
%U http://www.hxyxqk.com.cn/oa/DArticle.aspx?type=view&id=201106029