20232023年3月第54卷第3期年3月第54卷第3期226综合病例研究综合病例研究新医学新医学CT灌注成像辅助诊断单纯疱疹病毒1型脑炎一例符雄琳龙发青【摘要】单纯疱疹病毒性脑炎又称急性坏死性脑炎，是由疱疹病毒感染引起的脑实质炎症。CT灌注成像（CTP）可快速显示脑部组织灌注异常及脑组织受损情况，常被用于脑卒中的诊断，而被用于辅助诊断脑炎的文献报道较少。该文报道了1例通过CTP辅助诊断单纯疱疹病毒1型脑炎的59岁男性患者。该例患者起病急，突发右侧肢体抽搐伴发热，且伴有精神症状，不能配合完成MRI，故急行头颅CTP，结果显示其左侧颞叶灌注较右侧增加，不排除病毒性脑炎的诊断，遂于入院12h内泵注阿昔洛韦抗病毒治疗及予其他对症治疗，患者病情逐渐好转。入院后3d脑脊液病原体二代测序结果回报，明确诊断为单纯疱疹病毒1型脑炎。【关键词】单纯疱疹病毒性脑炎；单纯疱疹病毒1型；CT灌注成像CTPimagingassisteddiagnosisofherpessimplexvirustypeoneencephalitis:acasereportFuXionglin，LongFaqing.DepartmentofNeurology，theSecondAffiliatedHospitalofHainanMedicalCollege，Haikou570216，ChinaCorrespondingauthor，LongFaqing，E-mail:qingfalong@sina.com【Abstract】Herpessimplexvirusencephalitis（HSE），alsoknownasacutenecrotizingencephalitis，isaninflammationofbrainparenchymacausedbyherpesvirusinfection.CTperfusion（CTP）imaging，canquicklydisplayabnormalbraintissueperfusionandbraintissuedamage，whichiscommonlyusedforthediagnosisofstroke.UseofCTPintheauxiliarydiagnosisofencephalitishasbeenrarelyreported.Here，a59-year-oldmalecaseofHSE-1encephalitisdiagnosedbyCTPwasreported.Thepatienthadacuteonsetofrightlimbtwitchingcomplicatedwithfever，andmentalsymptoms.HefailedtocooperatewithMRI.Therefore，CTPwasperformedurgently.Theresultsshowedthattheperfusionofthelefttemporallobewashigherthanthatoftherightside.Thediagnosisofviralencephalitiscouldnotbeexcluded.Therefore，acyclovirwaspumpedforantiviraltherapyandothersymptomatictreatmentwasdeliveredwithin12hafteradmission，andtheconditionsweregraduallyimproved.At3dafteradmission，thediagnosisofHSE-1encephalitiswasconfirmedbythenext-generationsequencingofcerebrospinalfluidpathogens.【Keywords】Herpessimple...
