| Objective In order improve diagnostic skill of viral encephalitis, analysis of characteristics of cerebrospinal fluid, electroencephalogram, diffusion-weighted imaging performance and ADC value changes.Materials and Methods 80 cases of viral encephalitis were studied from January 2006 to May 2010 of affiliated Hospital of Ningxia Medical university. Retrospective analysis of the characteristics of the CSF, EEG, DWI performance, and re-measured the ADC values of lesions with viral encephalitis. 150 cases of normal adults as controls, their age, gender ratio consistent with the viral encephalitis patients, and measured the ADC values of the position which consistent with the viral encephalitis lesions.Results(1) CSF: 68 cases had increased leucocyte, With lymphocyte predominance,32 cases increased pressure, 30 cases increased protein. The CSF were re-examined between 10 to days, The leucocyte of 5 cases did not improve, following 3 weeks treatment the CSF were re-examined in 5 patients, three of them were recovered whereas no improvement was found in two of them..(2)EEG in 49patients, abnormal,41 cases,normal,8 cases. There were 23 cases with abnormalities,18 cases with moderately abnormal of abnormal patients, no severe abnormalities.Following 4 weeks treatment, EEG examination were performed again in 6 patients, 4 cases had improvement, 2 cases without significant change.(3) MRI and DWI: Lesions of viral encephalitis located in the frontal, temporal lobe, lateral ventricle, basal ganglia region-thalamus region. Lesions showed low signal on DWI in 3 cases, equal signal or slightly higher signal in 27 cases, high signal in 4 cases, and measured the ADC values of lesions. The ADC values of viral encephalitis with no lesions and normal adults were measured at the parts with lesion location corresponding. The ADC value of lesions of viral encephalitis is (1.12±0.09)×10-3mm2/s,(1.11±0.08)×10-3mm2/s,(1.08±0.06)×10-3mm2/s and(1.14±0.08)×10-3mm2/s; viral encephalitis with no lesions is(0.799±0.01)×10-3mm2/s,(0.808±0.02)×10-3mm2/s,(0.789±0.01)×10-3mm2/s and(0.779±0.01)×10-3mm2/s; Normal adults is(0.797±0.01)×10-3mm2/s,(0.802±0.01)×10-3mm2/s,(0.787±0.01)×10-3mm2/såŠ(0.776±0.01)×10-3mm2/s. Statistical analysis showed that the average ADC value of viral encephalitis was significantly higher than normal adults, the difference was significant (P<0.01). (4) The average ADC value of lesions within 7 days of viral encephalitis is(1.11±0.03)×10-3mm2/s; 8～30 days is(1.11±0.01)×10-3mm2/s; all higher than the contralateral normal brain tissue, the difference was statistically significant(P<0.01); the average ADC value of two groups were compared, the difference was not statistically significant(P>0.05).Conclusion (1) The leucocyte and protein of the CSF had increased, sugar and chloride was normal. (2) EEG was very sensitive, have higher diagnotic value(83.7%), but normal EEG can not completely rule out the diagnosis of viral encephalitis. (3) In this study, the common position of lesions is temporal, frontal, lateral side, the basal ganglia-thalamus region, and temporal is more common after MRI and DWI checks. (4) The lesions of viral encephalitis showed equal signal or slightly higher signal on DWI; The ADC values of viral encephalitis is higher than contralateral normal brain tissue and normal adult brain tissue,it has reference value of diagnosis for viral encephalitis. |
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