13例神经白塞病患者的临床及影像学特点分析

梁秋蕊 ;花放 ;李晓双 ;昝坤 ;时宏娟 ;祖洁 ;汪秀玲 ;徐凯 ;陈浩 ;崔桂云

神经损伤与功能重建 ›› 2018, Vol. 13 ›› Issue (7) : 338-343.

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神经损伤与功能重建 ›› 2018, Vol. 13 ›› Issue (7) : 338-343.
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13例神经白塞病患者的临床及影像学特点分析

  • 梁秋蕊1 ,花放2 ,李晓双1 ,昝坤2 ,时宏娟2 ,祖洁2 ,汪秀玲2 ,徐凯2 ,陈浩2 ,崔桂云2
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Clinical and Radiological Features of 13 Cases of Neuro-Behcet’s Disease

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摘要

目的:探讨13例神经白塞病患者的临床表现及影像学特点。方法:收集符合神经白塞病诊断标准的 13例住院患者的临床及影像学资料进行回顾性分析,总结其特点。结果:13例患者中头痛5例,肢体偏瘫5 例,头晕4例,视物模糊3例、合并癫痫发作3例;血液学检查示血沉、CRP等炎性指标升高,脑脊液检查示脑 脊液压力、白细胞计数、蛋白升高;头颅MRI可见双侧额叶、颞叶、基底节、放射冠区可见多发斑点状或斑片 状长T1、长T2信号影,FLAIR及DWI呈高信号,脑室脑池稍大,脑沟增宽,颅内血管检查可见非动脉粥样硬 化性狭窄甚至闭塞。结论:临床上疑似白塞病的患者,若同时伴有神经系统损害,需高度怀疑神经白塞病, 需进一步行相关血液学检查、头颅MRI平扫及增强、脑脊液、针刺试验等检查以确诊。

Abstract

To explore the clinical and imaging features of 13 cases of neuro-Behcet’s disease (NBD). Methods: A retrospective study was performed on 13 patients diagnosed with NBD. The data and imaging features were analyzed. Results: The main symptoms experienced by NBD patients were headache (5 cases), hemiplegia (5 cases), dizziness (4 cases), visual disturbance (3 cases), and epileptic seizures (3 cases). Biochemical examination of blood showed that all patients had increased inflammatory indexes such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Cerebrospinal fluid (CSF) examination showed increased CSF pressure, white blood cells (WBCs) count, and protein level. Brain magnetic resonance imaging (MRI) scans revealed multiple patches giving high signals on T1-weighted images, T2-weighted images, fluid-attenuated inversion recovery (FLAIR) images, and diffusion-weighted images (DWI) in the bilateral frontal lobes, temporal lobes, basal ganglia, and corona radiata. Additionally, slightly enlarged ventricles, widened sulcus, and stenosis in the intracranial vessels were also observed. Conclusion: NBD should be considered if the patient’s clinical characteristics suggest Behcet’s disease and are accompanied by neurological damage. Blood tests, plain and contrast-enhanced brain MRI scans, CSF examination, and pin-prick tests are required to confirm the diagnosis.

关键词

白塞病 / 神经白塞病 / 免疫炎症 / 磁共振成像 / 白细胞介素-6 / 脑脊液

Key words

Behcet’s disease

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梁秋蕊 ;花放 ;李晓双 ;昝坤 ;时宏娟 ;祖洁 ;汪秀玲 ;徐凯 ;陈浩 ;崔桂云. 13例神经白塞病患者的临床及影像学特点分析[J]. 神经损伤与功能重建. 2018, 13(7): 338-343
Clinical and Radiological Features of 13 Cases of Neuro-Behcet’s Disease[J]. Neural Injury and Functional Reconstruction. 2018, 13(7): 338-343

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