感染性心内膜炎颅内并发症的影像学表现

摘要

Objective To investigate the imaging features of the cerebral complications of infective endocarditis (IE)and the evolution process of infective cerebral infarction.Methods The clinical and imaging data from 5 patients diagnosed as IE with neurological complications were retrospectively and comprehensively reviewed,so that the imaging features of cerebral complications and infective cerebral infarctions were summarized.Results Among the 5 cases,3 showed multiple acute infarctions,including 2 massive ones.All the 5 cases showed multiple hemorrhagic lesions at different stages.The infarction and hemorrhage were mostly located at the corticalGmedullary junction.1 case of subarachnoid hemorrhage and 1 case of meningitis were also observed.Two massive infarctions mentioned above showed irregular patchy shape,which evolved into cerebral abscesses after 1 2 and 1 5 days of neurological symptoms showing up,then abscesses started shrinking after 33 and 3 1 days,respectively.Conclusion MRI can accurately reflect the features of cerebral complications of IE and the evolution process of infective cerebral infarctions,which provides evidences for physicians to make correct diagnoses and the treatment plans.%目的 探讨感染性心内膜炎(IE)颅内并发症的影像学表现及感染性脑梗死的演变规律.方法 回顾性分析 5 例 IE 并发神经系统症状的患者的临床及影像学资料,总结其颅内并发症及感染性脑梗死的影像学特点.结果 多发性急性梗死灶 3 例,其中大面积梗死 2 例;多发性不同时期出血灶 5 例;梗死灶和出血灶多位于灰白质交界处.急性蛛网膜下腔出血 1 例.脑膜炎 1例.2 例大面积脑梗死呈大片状,分别于神经系统症状出现后1 2 d、1 5 d形成脑脓肿,33 d、3 1 d脑脓肿变小.结论 MRI可以准确反映 IE颅内并发症表现特点及感染性脑梗死的发展过程,为临床提供诊治依据.